Organogenesis (ORGO) 10-K 1 Mar 23 2022 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Feb. 15, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY
Document Transition Report	false
Entity Registrant Name	ORGANOGENESIS HOLDINGS INC.
Entity Central Index Key	0001661181
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Public Float			$ 345.2
Trading Symbol	ORGO
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Address, State or Province	MA
Title of 12(b) Security	Class A Common Stock, $0.0001 par value
Security Exchange Name	NASDAQ
Document Annual Report	true
Entity Common Stock, Shares Outstanding		131,176,200
ICFR Auditor Attestation Flag	true
Entity File Number	001-37906
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	85 Dan Road
Entity Address, City or Town	Canton
Entity Address, Postal Zip Code	02021
Entity Tax Identification Number	98-1329150
City Area Code	781
Local Phone Number	575-0775
Auditor Name	RSM US LLP
Auditor Firm ID	49
Auditor Location	Boston, Massachusetts

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 102,478	$ 113,929
Restricted cash	812	599
Accounts receivable, net	89,450	82,460
Inventory	24,783	25,022
Prepaid expenses and other current assets	5,086	4,969
Total current assets	222,609	226,979
Property and equipment, net	102,463	79,160
Intangible assets, net	20,789	25,673
Goodwill	28,772	28,772
Operating lease right-of-use assets, net	43,192	49,144
Deferred tax asset, net	30,014	31,994
Other assets	1,520	1,537
Total assets	449,359	443,259
Current liabilities:
Current portion of deferred acquisition consideration		1,436
Current portion of term loan	4,538	2,656
Current portion of finance lease obligations		200
Current portion of operating lease obligations	11,708	11,785
Accounts payable	32,330	29,339
Accrued expenses and other current liabilities	26,447	37,289
Total current liabilities	75,023	82,705
Term loan, net of current portion	66,231	70,769
Operating lease obligations, net of current portion	41,314	46,893
Other liabilities	1,122	1,557
Total liabilities	183,690	201,924
Commitments and contingencies (Note 18)
Stockholders' equity:
Preferred stock, $0.0001 par value; 1,000,000 shares authorized; none issued
Common stock, $0.0001 par value; 400,000,000 shares authorized; 129,408,740 and 128,460,381 shares issued; 128,680,192 and 127,731,833 shares outstanding at December 31, 2021 and 2020, respectively	13	13
Additional paid-in capital	310,957	302,155
Accumulated deficit	(45,301)	(60,833)
Total stockholders' equity	265,669	241,335
Total liabilities and stockholders' equity	$ 449,359	$ 443,259

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2022	Dec. 31, 2021
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	400,000,000	400,000,000
Common stock, shares issued	131,647,677	129,408,740
Common stock, shares outstanding	130,919,129	128,680,192

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Net revenue	$ 450,893	$ 467,359	$ 338,298
Cost of goods sold	105,019	114,199	87,319
Gross profit	345,874	353,160	250,979
Operating expenses:
Selling, general and administrative	283,808	250,200	204,193
Research and development	39,762	30,742	20,086
Total operating expenses	323,570	280,942	224,279
Income from operations	22,304	72,218	26,700
Other expense, net:
Interest expense	(2,009)	(7,236)	(11,279)
Gain on settlement of deferred acquisition consideration			2,246
Loss on the extinguishment of debt		(1,883)
Other income (loss), net	(13)	(13)	97
Total other expense, net	(2,022)	(9,132)	(8,936)
Net income before income taxes	20,282	63,086	17,764
Income tax (expense) benefit	(4,750)	31,116	(530)
Net income	$ 15,532	$ 94,202	$ 17,234
Net income, per share:
Basic	$ 0.12	$ 0.73	$ 0.16
Diluted	$ 0.12	$ 0.70	$ 0.15
Weighted-average common shares outstanding
Basic	130,070,231	128,331,022	107,737,936
Diluted	132,383,152	133,662,659	111,360,831

CONSOLIDATED STATEMENTS OF REDE

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Previously Reported	Revision of Prior Period, Reclassification, Adjustment	CPN	Common Stock	Common Stock Previously Reported	Common Stock CPN	Additional Paid-in Capital	Additional Paid-in Capital Previously Reported	Additional Paid-in Capital CPN	Accumulated Deficit	Accumulated Deficit Previously Reported	Accumulated Deficit Revision of Prior Period, Reclassification, Adjustment
Balance at Dec. 31, 2019	$ 52,022				$ 10			$ 224,281			$ (172,269)
Balance (in shares) at Dec. 31, 2019					104,870,886
Exercise of stock options	2,823				$ 1			2,822
Exercise of stock options (in shares)					996,286
Issuance of common stock associated with acquisition				$ 7,986						$ 7,986
Issuance of common stock associated with acquisition (in shares)							1,947,953
Stock-based compensation expense	1,661							1,661
Stock issued in the 2020 Underwritten Public Offering, net of issuance costs of $4,647	60,082				$ 2			60,080
Stock issued in the 2020 Underwritten Public Offering, net of issuance costs of $4,647 (in shares)					19,916,708
Net income	17,234										17,234
Balance at Dec. 31, 2020	141,808				$ 13			296,830			(155,035)
Balance (in shares) at Dec. 31, 2020					127,731,833
Exercise of stock options	2,198							2,198
Exercise of stock options (in shares)					760,458
Stock-based compensation expense	3,864							3,864
Vesting of RSUs, net of shares surrendered to pay taxes	(737)							(737)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)					187,901
Adjustment due to settlement of GPO fee dispute			$ (700)										$ (700)
Net income	94,202	$ 94,902										$ 94,902
Balance at Dec. 31, 2021	$ 241,335	242,035			$ 13	$ 13		302,155	$ 302,155		(60,833)	(60,133)
Balance (in shares) at Dec. 31, 2021	128,680,192				128,680,192	128,680,192
Net income	$ (913)	87
Balance at Mar. 31, 2022	241,528	243,228
Balance at Dec. 31, 2021	$ 241,335	$ 242,035			$ 13	$ 13		302,155	$ 302,155		(60,833)	$ (60,133)
Balance (in shares) at Dec. 31, 2021	128,680,192				128,680,192	128,680,192
Exercise of stock options	$ 2,070							2,070
Exercise of stock options (in shares)	1,864,961				1,864,961
Issuance of common stock associated with acquisition				$ 828						$ 828
Issuance of common stock associated with acquisition (in shares)							203,485
Stock-based compensation expense	$ 6,552							6,552
Vesting of RSUs, net of shares surrendered to pay taxes	(648)							(648)
Vesting of RSUs, net of shares surrendered to pay taxes (in shares)					170,491
Net income	15,532										15,532
Balance at Dec. 31, 2022	$ 265,669				$ 13			$ 310,957			$ (45,301)
Balance (in shares) at Dec. 31, 2022	130,919,129				130,919,129

CONSOLIDATED STATEMENTS OF RE_2

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY (Parenthetical) $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($)
Other underwriting expenses net of reimbursement by underwriters	$ 4,647

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 15,532	$ 94,202	$ 17,234
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	5,845	5,781	4,438
Amortization of intangible assets	4,883	4,949	3,745
Amortization of operating lease right-of-use assets	7,303	5,946
Non-cash interest expense	434	346	236
Deferred interest expense	501	1,493	2,133
Deferred rent expense			1,273
Gain on settlement of deferred acquisition consideration			(2,246)
Deferred tax expense (benefit)	1,980	(31,976)	112
Loss on disposal of property and equipment	4,482	1,407	201
Provision recorded for doubtful accounts	1,781	2,999	1,183
Adjustment for excess and obsolete inventories	9,648	12,079	3,050
Stock-based compensation	6,552	3,864	1,661
Loss on extinguishment of debt		1,883
Change in fair value of Earnout liability		(3,985)	203
Changes in operating assets and liabilities:
Accounts receivable	(8,770)	(28,654)	(17,567)
Inventory	(9,410)	(9,302)	(6,700)
Prepaid expenses and other current assets	(378)	(34)	(355)
Operating leases	(7,006)	(6,156)
Accounts payable	3,260	3,847	(4,102)
Accrued expenses and other current liabilities	(11,850)	9,354	1,443
Other liabilities	72	(6,065)	(476)
Net cash provided by operating activities	24,859	61,978	5,466
Cash flows from investing activities:
Purchases of property and equipment	(33,898)	(31,220)	(17,678)
Cash paid for business acquisition			(5,820)
Net cash used in investing activities	(33,898)	(31,220)	(23,498)
Cash flows from financing activities:
Line of credit repayments, net		(10,000)	(23,484)
Term loan borrowings (repayments) under the 2019 Credit Agreement		(60,000)	10,000
Proceeds from term loan under the 2021 Credit Agreement, net of debt discount and issuance cost		73,174
Term loan repayments under the 2021 Credit Agreement	(2,813)	(938)
Proceeds from equity financing			64,729
Payment of equity issuance costs			(5,656)
Principal repayments of capital lease obligations	(200)	(2,630)	(2,427)
Proceeds from the exercise of stock options	2,070	2,198	2,823
Payments of withholding taxes in connection with RSUs vesting	(648)	(737)
Payments of deferred acquisition consideration	(608)	(483)	(3,517)
Payment to extinguish debt		(1,620)
Net cash provided by (used in) financing activities	(2,199)	(1,036)	42,468
Change in cash, cash equivalents and restricted cash	(11,238)	29,722	24,436
Cash, cash equivalents and restricted cash, beginning of year	114,528	84,806	60,370
Cash, cash equivalents and restricted cash, end of year	103,290	114,528	84,806
Supplemental disclosure of cash flow information:
Cash paid for interest	2,649	5,787	9,609
Cash paid for income taxes	1,201	607	61
Supplemental disclosure of non-cash investing and financing activities:
Reimbursement of offering expenses included in prepaid expenses and other current assets			1,009
Fair value of shares issued for business acquisition			7,986
Deferred acquisition consideration and earnout liability recorded for business acquisition	828		5,218
Purchases of property and equipment in accounts payable and accrued expenses	1,928	3,750	$ 2,391
Right-of-use assets obtained through lease obligations	$ 1,350	$ 53,793

Nature of Business and Basis of

Nature of Business and Basis of Presentation	12 Months Ended
	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business and Basis of Presentation	1. Nature of Business and Basis of Presentation Organogenesis Holdings Inc. (“ORGO” or the “Company”) is a leading regenerative medicine company focused on the development, manufacture, and commercialization of solutions for the Advanced Wound Care and Surgical & Sports Medicine markets. Several of the existing and pipeline products in the Company’s portfolio have Premarket Application (“PMA”) approval, or Premarket Notification 510(k) clearance from the United States Food and Drug Administration (“FDA”). The Company’s customers include hospitals, wound care centers, government facilities, ambulatory service centers (“ASCs”) and physician offices. The Company has one operating and reportable segment. COVID-19 pandemic On January 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations related to coronavirus (COVID-19) on May 11, 2023. While the COVID-19 pandemic has not materially adversely affected the Company’s financial results and business operations through the year ended December 31, 2022, the COVID-19 pandemic continues to present risks to the Company and the Company is unable to predict the impact that COVID-19 will have on its financial position and operating results in future periods.

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Significant Accounting Policies Restatement to Previously Issued Financial Statements In August 2022, the Company reached an agreement with a Group Purchasing Organization (“GPO”) to settle previously disputed GPO fees for $ 3,300 . The Company identified that part of the settlement fee should have been accrued as of March 31, 2022 and December 31, 2021. This error resulted in an overstatement of revenue and understatement of accrued expenses and other current liabilities and accumulated deficit in the financial statements included in the Company’s quarterly reports on Form 10-Q and the Company’s Annual Report previously filed with the SEC. The Company assessed the materiality of this error on prior period financial statements in accordance with the SEC Staff Accounting Bulletin Number 99, Materiality, and ASC 250-10, Accounting Changes and Error Corrections. The Company determined that this error was not material to the financial statements of any prior annual or interim period. To correct the immaterial misstatement, the Company restated its previously issued financial statements as follows: March 31, 2022 December 31, 2021 CONSOLIDATED BALANCE SHEETS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Accrued expenses and other current liabilities $ 32,419 $ 1,700 $ 34,119 $ 36,589 $ 700 $ 37,289 Total current liabilities $ 76,792 $ 1,700 $ 78,492 $ 82,005 $ 700 $ 82,705 Total liabilities $ 193,044 $ 1,700 $ 194,744 $ 201,224 $ 700 $ 201,924 Accumulated deficit $ ( 60,046 ) $ ( 1,700 ) $ ( 61,746 ) $ ( 60,133 ) $ ( 700 ) $ ( 60,833 ) Total stockholders’ equity $ 243,228 $ ( 1,700 ) $ 241,528 $ 242,035 $ ( 700 ) $ 241,335 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF OPERATIONS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Gross profit $ 73,037 $ ( 1,000 ) $ 72,037 $ 353,860 $ ( 700 ) $ 353,160 Income from operations $ 872 $ ( 1,000 ) $ ( 128 ) $ 72,918 $ ( 700 ) $ 72,218 Net income before income taxes $ 132 $ ( 1,000 ) $ ( 868 ) $ 63,786 $ ( 700 ) $ 63,086 Net income $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net income / (loss) $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Changes in operating assets and liabilities: Accrued expenses and other current liabilities $ ( 4,828 ) $ 1,000 $ ( 3,828 ) $ 8,654 $ 700 $ 9,354 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Revenue by Product Category: As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Advanced Wound Care $ 90,950 $ ( 860 ) $ 90,090 $ 430,839 $ ( 602 ) $ 430,237 Surgical & Sports Medicine $ 7,167 $ ( 140 ) $ 7,027 $ 37,220 $ ( 98 ) $ 37,122 Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Miscellaneous Items As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated GPO fees $ 619 $ 1,000 $ 1,619 $ 2,963 $ 700 $ 3,663 PuraPly revenue $ 53,300 $ ( 500 ) $ 52,800 $ 198,400 $ ( 350 ) $ 198,050 Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting periods. In preparing the consolidated financial statements, the estimates and assumptions that management considers to be significant and that present the greatest amount of uncertainty include revenue recognition; sales returns and credit losses; inventory reserve; recognition and measurement of current and deferred income tax assets and liabilities; the assessment of recoverability of long-lived assets, assessing impairment of goodwill; valuation of assets and liabilities that use unobservable inputs, and the valuation and recognition of stock-based compensation. Actual results and outcomes may differ significantly from those estimates and assumptions. Principles of Consolidation The consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc., and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. Segment Reporting Operating segments are defined as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker, or decision-making group, in making decisions on how to allocate resources and assess performance for the organization. The Company’s chief operating decision maker is the Chief Executive Officer. The Company’s chief operating decision maker reviews consolidated operating results to make decisions about allocating resources and assessing performance for the entire Company. Accordingly, the Company has determined that it has a single operating segment—regenerative medicine. The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The Company’s portfolio includes regenerative medicine products in various stages, ranging from preclinical to late stage development, and commercialized advanced wound care and surgical and sports medicine products which support healing across a wide variety of wound types at many different types of facilities. Cash and Cash Equivalents The Company primarily maintains its cash in bank deposit accounts in the United States which, at times, may exceed the federally insured limits. The Company has not experienced losses in such accounts and believes it is not exposed to significant credit risk on cash. The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. Restricted Cash The Company had restricted cash of $ 812 and $ 599 as of December 31, 2022 and 2021, respectivel y. Restricted cash represents employee deposits in connection with the Company’s health benefit plan. Accounts Receivable, Net Accounts receivable are stated at invoice value less estimated allowances for doubtful accounts. The Company continually monitors customer payments and maintains a reserve for estimated losses resulting from its customers’ inability to make required payments. The Company considers factors when estimating the allowance for doubtful accounts such as historical experience, credit quality, age of the accounts receivable balances, geography-related risks and economic conditions that may affect a customer’s ability to pay. In cases where there are circumstances that may impair a specific customer’s ability to meet its financial obligations, a specific allowance is recorded against amounts due, thereby reducing the net recognized receivable to the amount reasonably believed to be collectible. Accounts receivables are written off when deemed uncollectible. Recoveries of accounts receivables previously written off are recorded when received. Inventories Inventories are stated at the lower of cost (determined under the first-in first-out method) or net realizable value. Work in process and finished goods include materials, labor and allocated overhead. Inventories also include cell banks and the cost of tests mandated by regulatory agencies of the materials to qualify them for production. The Company regularly reviews inventory quantities on hand and records a provision to write down excess and obsolete inventory to its estimated net realizable value based upon management’s assumptions of future material usage, yields and obsolescence, which are a result of future demand and market conditions and the effective life of certain inventory items. The Company also tests other components of its inventory for future growth projections. The Company determines the average yield of the component and compares it to projected revenue to ensure it is properly reserved. Property and Equipment, Net Property and equipment are recorded at cost and depreciated over the estimated useful lives of the respective assets on a straight-line basis. As of December 31, 2022 and 2021, the Company’s property and equipment consisted of leasehold improvements, building, furniture and computers, and equipment. Property and equipment’s estimated useful lives are as follows: Leasehold improvements Lesser of the life of the lease or the economic life of the asset Building 30 years Furniture and computers 3 - 5 years Equipment 5 - 10 years Upon retirement or sale, the cost of assets disposed of, and the related accumulated depreciation are removed from the accounts and any resulting gain or loss is included in the consolidated statement of operations. Expenditures for repairs and maintenance are charged to expense as incurred. Expenditures for major improvements that extend the useful lives of the related asset are capitalized and depreciated over their remaining estimated useful lives. Construction in progress costs are capitalized when incurred until the assets are placed in service, at which time the costs will be transferred to the related property and equipment, and depreciated over their respective useful lives. Goodwill Goodwill represents the excess of the purchase price of an acquired business over the fair value of the identifiable assets acquired and liabilities assumed. Goodwill is not amortized, but is tested for impairment at least annually (as of December 31), or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. Circumstances that could trigger an impairment test include, but are not limited to, a significant adverse change in the business climate or legal factors, an adverse action or assessment by a regulator, or unanticipated competition. The Company operates as one segment, which is considered to be the sole reporting unit, and therefore goodwill is tested for impairment at the consolidated level. In accordance with ASC Topic 350, Intangibles - Goodwill and Other, the Company may first assess qualitative factors to determine whether it is necessary to perform the quantitative goodwill impairment test. If after assessing the totality of events or circumstances, the Company determines that it is more likely than not (i.e. greater than 50% likelihood) that the fair value of the reporting unit is less than its carrying amount, then the quantitative test is required. Otherwise, no further testing is required. Alternatively, the Company can bypass the qualitative assessment and proceed directly to the quantitative test. The quantitative goodwill impairment test requires the Company to estimate and compare the fair value of the reporting unit with its carrying value. If the fair value of the reporting unit exceeds the carrying value of the net assets, goodwill is not impaired. If the fair value of the reporting unit is less than the carrying value, the difference is recorded as an impairment loss up to the amount of goodwill. At December 31, 2022, we elected to perform a quantitative analysis directly. We used the Company’s market capitalization to approximate the fair value of the reporting unit. The fair value exceeded the carrying value and no impairment was recorded. There was no impairment of goodwill recorded during the years ended December 31, 2022 , 2021, or 2020. Intangible Assets Subject to Amortization Intangible assets include intellectual property either owned by the Company or for which the Company has a license. Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired. Intangible assets are reported net of accumulated amortization, separately from goodwill. Intangible assets with finite lives are amortized over their estimated useful lives. Intangible assets include developed technology and patents, trade names, trademarks, customer relationships and non-compete agreements obtained through business acquisitions. Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated metho d based on the following estimated useful lives: Trade names and trademarks 1 - 12 years Developed technology 6 - 12 years Customer relationships 10 years Non-compete agreements 5 years Impairment of Long-Lived Assets Long-lived assets consist primarily of property and equipment. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Factors that the Company considers in deciding when to perform an impairment review include, but not limited to, significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets. When such an event occurs, the Company determines whether there has been impairment by comparing the anticipated undiscounted future net cash flows to the related asset group’s carrying value. If an asset is determined to be impaired, the asset is written down to fair value, which is determined based either on discounted cash flows or appraised value, depending on the nature of the asset. The Company did not record any impairment of long-lived assets during the years ended December 31, 2022 , 2021, or 2020. Revenue Recognition Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to this single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideration Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and GPO fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as a reduction of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or changes in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction of revenue and the establishment of a liability that is included in accrued expenses in the accompanying consolidated balance sheets in the period the related product revenue is recognized. GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of the product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue based on the substance of the relationship of all parties involved in the transaction. For the years ended December 31, 2022 , 2021, and 2020, the Company recorded GPO fees of $ 6,654 , $ 3,663 , and $ 3,572 , respectively, as a direct reduction of revenue. Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a contract has a significant financing component if the expectation at contract inception is such that the period between payment by the customer and the transfer of the promised products to the customer will be one year or less, which is the case with substantially all customers. Applying the practical expedient in ASC 340-40-25-4, the Company recognizes the incremental costs of obtaining contracts as an expense when incurred if the amortization period of the assets that the Company otherwise would have recognized is one year or less. These costs are included in selling, general, and administrative expenses. Applying the practical expedient in ASC 606-10-25-18B, the Company accounts for shipping and handling activities related to contracts with customers as costs to fulfill the promise to transfer the associated products. The Company records the related costs as part of the cost of goods sold. Disaggregation of Revenue The following table sets forth revenu e by product category: Year Ended December 31, 2022 2021 2020 Advanced Wound Care revenue $ 422,231 $ 430,237 $ 294,624 Surgical and Sports Medicine revenue 28,662 37,122 43,674 Total revenue $ 450,893 $ 467,359 $ 338,298 For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue. Stock-Based Compensation The Company measures stock-based awards granted based on the fair value of the awards on the date of grant and recognizes compensation expense for those awards over the requisite service period, which is generally the vesting period of the respective award. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Generally, the Company issues stock-based awards with only service-based vesting conditions and records the expense for these awards using the straight-line method. The Company has not issued any stock-based awards with performance-based vesting conditions. The Company recognizes stock-based compensation expense within selling, general and administrative expenses in the consolidated statement of operations for all share-based payments based upon the estimated grant-date fair value for the awards expected to ultimately vest. The fair value of each restricted stock unit grant is based on the fair market value of the Company’s Class A common stock on the date of grant. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. The Company has been a public company for a short period of time, has limited public float and lacks company-specific historical and implied volatility information for its Class A common stock. Therefore, it estimates its expected stock price volatility based on the historical volatility of publicly traded peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends on its Class A common stock and does not expect to pay any cash dividends in the foreseeable future. Advertising Advertising costs are expensed as incurred and are included in selling, general and administrative expenses in the consolidated statements of operations. Advertising costs were approximately $ 4,812 , $ 5,522 , and $ 2,722 , for the years ended December 31, 2022 , 2021, and 2020, respectively. Research and Development Costs Research and development expenses include personnel costs for the Company’s research and development personnel, expenses related to improvements in manufacturing processes, enhancements to the Company’s currently available products, and additional investments in the product and platform development pipeline. Research and development expenses also include expenses for clinical trials. The Company expenses research and development costs as incurred. Foreign Currency The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting from re-measurement of assets and liabilities held in foreign currencies and transactions settled in a currency other than the functional currency are included separately as non-operating income or expense in the consolidated statements of operations as a component of other expense, net. The foreign currency amounts recorded for all periods presented were insignificant. Valuation of Contingent Purchase Earnout In connection with the acquisition of CPN, the Company recognized a non-current liability for the fair value of the contingent consideration (the “Earnout”) at the time of the acquisition in 2020. The Earnout liability was classified as a Level 3 measurement for which fair value was derived from inputs that were unobservable and significant to the overall fair value measurement. The fair value of such Earnout liability was estimated using a Monte Carlo simulation model that utilized key assumptions including forecasted revenues and volatilities of the underlying financial metrics during the Earnout period. The Company assessed the fair value of the Earnout liability at each reporting period. Any subsequent changes in the estimated fair value of the liability were reflected in selling, general and administrative expenses until the liability was settled. Income Taxes The Company accounts for income taxes using the asset and liability method which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined on the basis of the differences between the consolidated financial statement and the tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company quarterly assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. In determining whether a valuation allowance for deferred tax assets is necessary, the Company analyzes both positive and negative evidence related to the realization of deferred tax assets, including projected future taxable income, recent financial results and estimates of future reversals of deferred tax assets and liabilities. In addition, the Company considers whether it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. In consideration of the factors discussed above, in the fourth quarter of 2021, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on the net U.S. deferred tax assets as of December 31, 2021, resulting in a benefit of $ 48.3 million in income taxes. The Company maintained the same position that its net U.S. deferred tax assets did not require a valuation allowance as of December 31, 2022. See footnote “15. Income Taxes.” The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the consolidated financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties. Fair Value of Financial Instruments Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The carrying values of accounts receivable, inventory, prepaid expenses and other current assets, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The fair value of the Earnout liability was determined according to Level 3 inputs in the fair value hierarchy described above (see footnote “4. Fair Value Measurement of Financial Instruments”). The carrying values of outstanding borrowings under the Company’s debt arrangements (see footnote “12. Long-Term Debt Obligations”) approximate their fair values as determined based on a discounted c ash flow model, which represents a Level 3 measurement. Earnings (Loss) per Share (EPS) The Company determines earnings (loss) per share in accordance with the authoritative guidance in ASC Topic 260, Earnings Per Share . The Company has one class of common stock (Class A common stock) for purposes of the EPS calculation and therefore computes basic EPS by dividing net income (loss) by the weighted average number of common shares outstanding for the applicable period. Diluted EPS is computed in the same manner as basic EPS, except that the number of shares is computed by giving effect to all potential dilutive common shares. For purpose of this calculation, outstanding stock options, and unvested restricted stock are considered potential dilutive common shares. Emerging Growth Company Before December 31, 2021, the Company was an “emerging growth company,” as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. Section 107 of the JOBS Act provides that an emerging growth company can take advantage of the extended transition period afforded by the JOBS Act for the implementation of new or revised accounting standards. The Company elected to use the extended transition period for complying with new or revised accounting standards (such as ASU 2016-02, Leases (Topic 842)) and, as a result of this election, the Company’s financial statements prior to 2021 may not be comparable to companies that comply with public company effective dates. Effective December 31, 2021, the Company is no longer an emerging growth company. Recently Adopted Accounting Pronouncements In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”). ASU 2020-04 provides temporary optional expedients and exceptions to the US GAAP guidance on contract modifications and hedge accounting to ease the financial reporting burdens related to the expected market transition from the London Interbank Offered Rate (LIBOR) and other interbank offered rates to alternative reference rates. In January 2021, the FASB issued ASU No. 2021-01, Reference Rate Reform (Topic 848): Scope (“ASU 2021-01”), to clarify certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting to apply to derivatives that are affected by the discounting transition. Both ASU 2020-04 and ASU 2021-01 are effective upon issuance through December 31, 2022. In December 2022, the Company executed an amendment to its debt agreement, replacing LIBOR with the secured overnight financing rate (“SOFR”). The Company utilized the relief provided in these ASUs. As the amendment did not affect the amount or timing of the contractual cash flows and the contemporaneous modifications to the other terms were related to the reference rate reform, the amendment was not substantial in accordance with ASC 848-20-35-8 . Therefore, the amendment did not impact the Company’s consolidated financial statements. Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). Subsequent to the issuance of ASU 2016-13, the FASB has issued the following updates: ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses , ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging , and Topic 825 , Financial Instruments , ASU 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief and ASU 2019-11, Codification Improvements to Topic 326 , Financial Instruments—Credit Losses . The objective of ASU 2016-13 and all the related updates is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit

Acquisition

Acquisition	12 Months Ended
	Dec. 31, 2022
Business Combinations [Abstract]
Acquisition	3. Acquisition On September 17, 2020 (the “Acquisition Date”), the Company acquired certain assets and assumed certain liabilities of CPN Biosciences, LLC (“CPN”) pursuant to an asset purchase agreement dated July 24, 2020. CPN offered a physician office management solution and advanced wound care products. The aggregate consideration amounted to $ 19,024 as of the Acquisition Date, consisting of $ 6,427 in cash, 2,151,438 shares of the Company’s Class A common stock with a fair value of $ 8,815 , and contingent consideration (the “Earnout”) with a fair value of $ 3,782 . On the Acquisition Date, the Company paid $ 5,820 in cash and issued 1,947,953 shares of the Company’s Class A common stock. The remaining consideration of $ 1,436 was held back and was released in April 2022 by the Company paying $ 608 in cash and issuing 203,485 shares of the Company’s Class A common stock to the former equity holders of CPN. The Company was obligated to pay the Earnout to CPN’s former equity holders if CPN’s legacy product revenue in the Earnout Period (July 1, 2021 to June 30, 2022), exceeded CPN’s 2019 revenue. The amount of the Earnout, if any, would be equal to 70 % of the excess and would be payable 60 days after the expiration of the Earnout Period. As of the conclusion of the Earnout Period on June 30, 2022, the Company calculated the Earnout liability to be $ 0 . During the Earnout Period, the Company assessed the fair value of the Earnout liability at each reporting period. Subsequent changes in the estimated fair value of the liability were reflected in earnings until the liability was settled. S ee footnote “4. Fair Value Measurement of Financial Assets and Liabilities”.

Fair Value Measurement of Finan

Fair Value Measurement of Financial Instruments	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurement of Financial Instruments	4. Fair Value Measurement of Financial Instruments Earnout Liability In connection with accounting for the CPN acquisition on September 17, 2020, the Company recorded an Earnout liability of $ 3,782 on the Acquisition Date, representing the fair value of contingent consideration payable upon the achievement of a certain revenue target. The Earnout liability was classified as a Level 3 measurement within the fair value hierarchy for which fair value was derived from inputs that were unobservable and significant to the overall fair value measurement. The fair value of such Earnout liability was estimated using a Monte Carlo simulation model that utilized key assumptions including forecasted revenues and volatilities of the underlying financial metrics during the Earnout Period. The Earnout Period ended on June 30, 2022 and the Company calculated the Earnout liability to be $ 0 . Before its settlement, the Company assessed the fair value of the Earnout liability at each reporting period. Any subsequent changes in the estimated fair value of the liability were reflected in selling, general and administrative expenses until the liability was settled. For more information about the Earnout liability, refer to Note “3. Acquisition”. The following table provides a roll-forward of the fair value of the Company’s Earnout liability, for which fair value was determined using Level 3 inputs until the end of the Earnout Period on June 30, 2022. Earnout liability Balance as of December 31, 2019 $ - Acquisition Date fair value 3,782 Change in fair value 203 Balance as of December 31, 2020 3,985 Change in fair value ( 3,985 ) Balance as of December 31, 2021 - Change in fair value - Balance as of June 30, 2022 $ - The Company did not have any financial assets and liabilities measured at fair value on a non-recurring basis as of December 31, 2022 and 2021.

Accounts receivable, net

Accounts receivable, net	12 Months Ended
	Dec. 31, 2022
Receivables [Abstract]
Accounts receivable, net	5. Accounts receivable, net Accounts receivab le consisted of the following: December 31, 2022 2021 Accounts receivable $ 95,812 $ 87,613 Less - allowance for doubtful accounts ( 6,362 ) ( 5,153 ) $ 89,450 $ 82,460 The Company’s allowance for doubtful accounts was co mprised of the following: Balance as of December 31, 2020 $ 2,669 Additions 2,999 Write-offs ( 515 ) Balance as of December 31, 2021 $ 5,153 Additions 1,781 Write-offs ( 572 ) Balance as of December 31, 2022 $ 6,362

Inventories

Inventories	12 Months Ended
	Dec. 31, 2022
Inventory Disclosure [Abstract]
Inventories	6. Inventories Inventories, net of related reserves for excess and obsolescence, consisted of the following: December 31, 2022 2021 Raw materials $ 12,282 $ 9,023 Work in process 1,022 991 Finished goods 11,479 15,008 $ 24,783 $ 25,022 Raw materials include various components used in the Company’s manufacturing process. The Company’s excess and obsolete inventory review process includes analysis of sales forecasts and historical sales as compared to inventory levels and working with operations to maximize recovery of excess inventory. During the years ended December 31, 2022, 2021, and 2020, the Company charged $ 9,648 , $ 12,079 , and $ 3,050 , respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations . The significant increase in inventory excess and obsolescence charge in the recent two years is due to certain inventory with very short shelf life and varying production yields.

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets	12 Months Ended
	Dec. 31, 2022
Payables and Accruals [Abstract]
Prepaid Expenses and Other Current Assets	7. Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets co nsisted of the following: December 31, 2022 2021 Subscriptions $ 4,211 $ 2,745 Conferences and marketing expenses 106 538 Deposits 635 1,216 Insurance 54 358 Other 80 112 $ 5,086 $ 4,969 Deposits are funds held by vendors which are expected to be released within twelve months and therefore they are recorded as current assets.

Property and Equipment, Net

Property and Equipment, Net	12 Months Ended
	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	8. Property and Equipment, Net Property and equipment consiste d of the following: December 31, 2022 2021 Leasehold improvements $ 37,607 $ 30,531 Building 4,943 4,943 Furniture, computers and equipment 57,147 53,959 99,697 89,433 Accumulated depreciation ( 62,798 ) ( 57,729 ) Construction in progress 65,564 47,456 $ 102,463 $ 79,160 Depreciation expense was $ 5,845 , $ 5,781 and $ 4,438 , for the years ended December 31, 2022, 2021, and 2020, respectively. Construction in progress primarily represents unfinished construction work on a purchased building located on the Company’s Canton, Massachusetts campus and improvements at the Company’s leased facilities in Canton and Norwood, Massachusetts. The increase in the construction in progress is a result of the Company’s ongoing efforts to consolidate its manufacturing operations in various locations into Massachusetts facilities to reduce the Company’s cost structure and improve operating efficiency. During the year ended December 31, 2022, the Company recorded a charge of $ 4,200 for the sale and donation of some equipment related to the construction in progress in one of its Canton, Massachusetts facilities. The disposal was the result of a change in the design of the construction plan for the manufacturing facility and the determination that this equipment was no longer compatible with the ongoing design. During 2022, the Company decided to pause the construction of this manufacturing facility due to inflation and market conditions that adversely impacted construction projects across the biotechnology and life sciences industries. In connection with this decision, the Company recorded a charge of $ 632 as cancellation fees to various vendors. These charges were included in selling, general and administrative expenses on the consolidated statements of operations for the year ended December 31, 2022. This facility was part of the primary assets in one of the Company's two asset groups. The Company considered the equipment disposal and construction pause, among other things, to be triggering events under ASC 360. The triggering events indicated that the Company’s long-lived assets might be impaired. The Company performed a recoverability test during 2022, on the affected asset group in accordance with ASC 360, Property, Plant and Equipment . The estimated undiscounted cash flow directly attributable to the asset group exceeded the carrying value of the asset group. Therefore, no impairment was identified.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	9. Goodwill and Intangible Assets Goodwill was $ 28,772 as of D ecember 31, 2022 and 2021. Identifiable intangible assets consisted of the following a s of December 31, 2022: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ ( 21,164 ) $ 11,456 Trade names and trademarks 2,080 ( 1,393 ) 687 Customer relationship 10,690 ( 2,450 ) 8,240 Independent sales agency network 4,500 ( 4,500 ) - Patent 7,623 ( 7,623 ) - Non-compete agreements 1,010 ( 604 ) 406 Total $ 58,523 $ ( 37,734 ) $ 20,789 Identifiable intangible assets consisted of the following as of December 31, 2021: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ ( 17,709 ) $ 14,911 Trade names and trademarks 2,080 ( 1,183 ) 897 Customer relationship 10,690 ( 1,381 ) 9,309 Independent sales agency network 4,500 ( 4,500 ) - Patent 7,623 ( 7,623 ) - Non-compete agreements 1,010 ( 454 ) 556 Total $ 58,523 $ ( 32,850 ) $ 25,673 Amortization of intangible assets, calculated on a straight-line basis or using an accelerated method, which reflects the pattern in which the economic benefits of the intangible assets are consumed, was $ 4,883 , $ 4,949 and $ 3,745 for the years ended December 31, 2022, 2021, and 2020, respectively. Estimated future annual amortization expense related to these in tangible assets is as follows: 2023 $ 4,918 2024 3,403 2025 3,323 2026 3,043 2027 2,283 Thereafter 3,819 Total $ 20,789

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	12 Months Ended
	Dec. 31, 2022
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	10. Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following: December 31, 2022 2021 Personnel costs $ 17,113 $ 26,865 Royalties 3,320 3,458 Accrued but unpaid lease obligations and interest 2,463 3,963 Accrued settlement fee - 700 Accrued taxes 2,625 1,160 Other 926 1,143 $ 26,447 $ 37,289 The accrued but unpaid lease obligations and the interest accrual on these obligations are related to the buildings in Canton, Massachusetts. See footnote “17. Leases”. See footnote “2. Significant Accounting Policies” for accrued settlement fee.

Restructuring

Restructuring	12 Months Ended
	Dec. 31, 2022
Restructuring and Related Activities [Abstract]
Restructuring	11. Restructuring In order to reduce the Company’s cost structure and improve operating efficiency, the Company consolidates its manufacturing operations in various locations into Massachusetts facilities. On October 21, 2020, the Company committed to a plan to restructure the workforce and operations in its La Jolla, California facilities. The restructuring involved 65 employees and was substantially completed as of December 31, 2021, with certain facility and storage activities continuing through 2024. On Mar ch 9, 2022, the Company committed to a plan to restructure the workforce and operations in its Birmingham, Alabama facilities. The restructuring involved approximately 25 employees and was substantially completed as of December 31, 2022, with minimal expenses to be incurred in 2023. As a result of the restructuring activities, the Company incurred pre-tax charges of $ 2,268 , $ 4,704 and $ 618 in the years ended 2022, 2021, and 2020, respectively. These charges were included in selling, general and administrative expenses in the consolidated statements of operations. The liability related to the restructuring activities was $ 1,192 and $ 3,168 as of December 31, 2022 and 2021, respectively, and was included in accrued expenses and other current liabilities in the consolidated balance sheets. The following table provides a roll-forward of the restructuring liability. Employee Other Total Liability balance as of December 31, 2019 $ - $ - $ - Expenses 618 - 618 Cash distributions - - - Liability balance as of December 31, 2020 618 - 618 Expenses 3,513 1,191 4,704 Cash distributions ( 1,614 ) ( 540 ) ( 2,154 ) Liability balance as of December 31, 2021 2,517 651 3,168 Expenses 1,557 711 2,268 Cash distributions ( 3,064 ) ( 1,180 ) ( 4,244 ) Liability balance as of December 31, 2022 $ 1,010 $ 182 $ 1,192

Long-Term Debt Obligations

Long-Term Debt Obligations	12 Months Ended
	Dec. 31, 2022
Long-Term Debt, Unclassified [Abstract]
Long-Term Debt Obligations	12. Long-Term Debt Obligations December 31, 2022 2021 Line of credit $ - $ - Term loan 71,250 74,062 Less debt discount and debt issuance cost ( 481 ) ( 637 ) Term loan, net of debt discount and debt issuance cost $ 70,769 $ 73,425 2021 Credit Agreement In August 2021, the Company, as borrower, its subsidiaries, as guarantors, and Silicon Valley Bank (“SVB”), and the several other lenders thereto (collectively, the “Lenders”) entered into a credit agreement, as amended (the “2021 Credit Agreement”), providing for a term loan facility not to exceed $ 75,000 (the “Term Loan Facility”) and a revolving credit facility not to exceed $ 125,000 (the “Revolving Facility”). The Company’s obligations to the Lenders are secured by substantially all of the Company’s assets, including intellectual property. Capitalized terms used herein and not otherwise defined are defined as set forth in the 2021 Credit Agreement. Advances made under the 2021 Credit Agreement may be either SOFR Loans or ABR Loans, at the Company’s option. For SOFR Loans, the interest rate is a per annum interest rate equal to the Adjusted Term SOFR plus an Applicable Margin between 2.00 % to 3.25 % based on the Total Net Leverage Ratio. For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) the Adjusted Term SOFR rate plus 1.0%, plus (2) an Applicable Margin between 1.00 % to 2.25 % based on the Total Net Leverage Ratio. The 2021 Credit Agreement requires the Company to make consecutive quarterly installment payments equal to the following: (a) from September 30, 2021 through and including June 30, 2022, $ 469 ; (b) from September 30, 2022 through and including June 30, 2023, $ 938 ; (c) from September 30, 2023 through and including June 30, 2025, $ 1,406 and (d) from September 30, 2025 and the last day of each quarter thereafter until August 6, 2026 (the “Term Loan Maturity Date”), $ 1,875 . The Company may prepay the Term Loan Facility. Once repaid, amounts borrowed under the Term Loan Facility may not be re-borrowed. The Company must pay in arrears, on the first day of each quarter prior to August 6, 2026 (the “Revolving Termination Date”) and on the Revolving Termination Date, a fee for the Company’s non-use of available funds (the “Commitment Fee”). The Commitment Fee rate is between 0.25 % to 0.45 % based on the Total Net Leverage Ratio. The Company may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal and unpaid accrued interest. Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants including the Consolidated Fixed Charge Coverage Ratio and Consolidated Total Net Leverage Ratio, tested quarterly. In addition, the Company is also required to make representations and warranties and comply with certain non-financial covenants that are customary in loan agreements of this type, including restrictions on the payment of dividends, repurchase of stock, incurrence of indebtedness, dispositions and acquisitions. The Company recorded debt issuance costs and related fees of $ 604 in connection with entering into the Term Loan Facility, which are recorded as a reduction of the carrying value of the term loan on the Company’s consolidated balance sheets. In connection with entering into the Revolving Facility, the Company recorded debt issuance costs and related fees of $ 1,223 , which are recorded as other assets. Both of these costs are being amortized to interest expense through the maturity date of the facilities. As of December 31, 2022 and 2021, the Company had outstanding borrowings o f $ 71,250 and $ 74,062 under the Term Loan Facility, respectively, and $ 0 under the Revolving Facility with $ 125,000 available for future revolving borrowings. Future payments of the 2021 Credit Agreement, as of December 31, 2022, are as follows for th e calendar years ending December 31: 2023 $ 4,687 2024 5,625 2025 6,563 2026 54,375 Total $ 71,250 2019 Credit Agreement In March 2019, the Company, its subsidiaries and SVB, and the several other lenders thereto entered into a credit agreement, as amended (the “2019 Credit Agreement”), providing for a term loan facility of $ 40,000 and a revolving credit facility of up to $ 60,000 . Both facilities were set to mature in 2024 . The interest rate for the term loan facility was a floating per annum interest rate equal to the greater of 3.75 % above the Wall Street Journal Prime Rate and 9.25 % . The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%. If the Company elected to prepay the loan or terminate the facilities, the Company was required to pay a certain percentage of the outstanding principal as a prepayment fee. A final payment fee (the “Final Payment”) of 6.5 % multiplied by the original aggregate principal amount of term loan facility was due upon the earlier to occur of the maturity date of the term loan or prepayment of all outstanding principal. In August 2021, upon entering into the 2021 Credit Agreement, the Company paid an aggregate amount of $ 70,559 due under the 2019 Credit Agreement, including unpaid principal, accrued interest, the Final Payment and a prepayment fee, with proceeds from the 2021 Credit Agreement, and the 2019 Credit Agreement was terminated. Upon termination of the 2019 Credit Agreement, the Company recognized $ 1,883 as loss on the extinguishment of the loan for the year ended December 31, 2021.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2022
Equity [Abstract]
Stockholders' Equity	13. Stockholders’ Equity As of December 31, 2022, the issued shares of Class A common stock include 728,548 treasury shares that were reacquired in connection with the redemption of redeemable shares in March 2019. Each share of Class A common stock entitles the holder to one vote on all matters submitted to the stockholders for a vote. Class A common stockholders are entitled to receive dividends, as may be declared by the Board of Directors to the extent permissible under the 2021 Credit Agreement. Through December 31, 2022, no cash dividends have been declared or paid. At December 31, 2022 and 2021, the Company reserved the following shares of Class A common stoc k for future issuance: December 31, 2022 2021 Shares reserved for issuance for outstanding options 5,931,742 6,596,969 Shares reserved for issuance for outstanding restricted stock units 1,381,500 764,871 Shares reserved for issuance for future grants 11,394,962 5,644,691 Total shares of authorized common stock reserved for future issuance 18,708,204 13,006,531 2020 Underwritten Public Offering In November 2020, the Company closed a public offering (the “2020 Underwritten Public Offering”) of 17,500,000 shares of the Company’s Class A common stock, par value $ 0.0001 per share, at a price per share to the public of $ 3.25 , less underwriting discounts and commissions. In connection with this offering, the Company issued a total of 19,916,708 shares of Class A common stock with gross proceeds of $ 64,729 and net proceeds of $ 59,073 after deducting underwriter discounts, payment of the fee to the Avista entities and other offering expenses in the aggregate amount of $ 5,656 . $ 1,009 of the offering expenses which should have been reimbursed to the Company by the underwriters on November 17, 2020 was not received until January 2021 and was included in prepaid expenses and other current assets on the consolidated balance sheet as of December 31, 2020. $ 4,647 , representing the offering expenses net of the reimbursement was recorded to additional paid-in capital against the proceeds received.

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Equity Incentive Plan Share-Based Compensation	14. Share-Based Compensation Stock Incentive Plans-the 2018 Plan On November 28, 2018, the Board of Directors of the Company adopted, and on December 10, 2018, the Company’s stockholders approved, the Organogenesis 2018 Equity and Incentive Plan (the “2018 Plan”). The purposes of the 2018 Plan are to provide long-term incentives and rewards to the Company’s employees, officers, directors and other key persons (including consultants), to attract and retain persons with the requisite experience and ability, and to more closely align the interests of such employees, officers, directors and other key persons with the interests of the Company’s stockholders. The 2018 Plan authorizes the Company’s Board of Directors or a committee of not less than two independent directors (in either case, the “Administrator”) to grant the following types of awards: non-statutory stock options; incentive stock options; restricted stock awards; restricted stock units; stock appreciation rights; unrestricted stock awards; performance share awards; and dividend equivalent rights. The 2018 Plan is administered by the Company’s Board of Directors. At the adoption of the 2018 Plan, a total of 9,198,996 shares of Class A common stock was authorized to be issued (subject to adjustment in the case of any stock dividend, stock split, reverse stock split, or similar change in capitalization of the Company). In June 2022, the 2018 Plan was amended to increase the number of shares of Class A common stock reserved for issuance by 7,826,970 shares. Stock Incentive Plans-the 2003 Plan The Organogenesis 2003 Stock Incentive Plan (the “2003 Plan”), provides for the Company to issue restricted stock awards, or to grant incentive stock options or non-statutory stock options. Incentive stock options may be granted only to the Company’s employees. Restricted stock awards and non-statutory stock options may be granted to employees, members of the Board of Directors, outside advisors and consultants of the Company. Effective December 10, 2018, no additional awards may be made under the 2003 Plan and as a result (i) any shares in respect of stock options that are expired or terminated under the 2003 Plan without having been fully exercised will not be available for future awards; (ii) any shares in respect of restricted stock that are forfeited to, or otherwise repurchased by the Company, will not be available for future awards; and (iii) any shares of Class A common stock that are tendered to the Company by a participant to exercise an award will not be available for future awards. Stock-Based Compensation Expense Stock options awarded under the stock incentive plans expire 10 years after the grant date and typically vest over four or five years . Restricted stock units awarded typically vest over four years. During the years ended December 31, 2022, 2021, and 2020, the Company recorded stock-based compensation expenses of $ 6,552 , $ 3,864 , and $ 1,661 , respectively, within selling, general and administrative expenses on the consolidated statements of operations. Restricted Stock Units (RSUs) During the year ended December 31, 2022, the Company granted 979,257 time-based restricted stock units to its employees, executives and the Board of Directors. Each restricted stock unit represents the contingent right to receive one share of the Company’s Class A common stock. The fair value of the restricted stock units was based on the fair market value of the Company’s stock on the date of grant. The activity of restricted stock units is set forth below: Weighted Average Number Grant Date of Shares Fair Value Unvested at December 31, 2021 764,871 $ 7.52 Granted 979,257 7.56 Vested ( 249,106 ) 7.34 Canceled/Forfeited ( 113,522 ) 7.00 Unvested at December 31, 2022 1,381,500 $ 7.62 As of December 31, 2022, the total unrecognized compensation cost related to unvested restricted stock units expected to vest was $ 5,692 and the weighted average remaining recognition period for unvested awards was 2.60 years. Stock Options The stock options granted during the years ended December 31, 2022, and 2021 were 1,418,224 and 1,069,658 , respectively. The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis: Year Ended December 31, 2022 2021 Risk-free interest rate 1.92 % 0.83 % Expected term (in years) 6.25 6.22 Expected volatility 50.66 % 39.31 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 8.03 $ 13.57 Underlying stock price $ 7.87 $ 13.57 These assumptions resulted in an estimated weighted-average grant-date fair value per share of stock options granted during the years ended December 31, 2022 and 2021 of $ 3.94 and $ 5.32 , respectively. The following table summarizes the Company’s stock option activity since December 31, 2021: Weighted Weighted Average Average Remaining Aggregate Number of Exercise Contractual Intrinsic Shares Price Term Value (in years) Outstanding as of December 31, 2021 6,596,969 $ 4.10 5.20 38,524 Granted 1,418,224 8.03 Exercised ( 1,864,961 ) 1.11 8,475 Canceled / forfeited ( 218,490 ) 6.04 Outstanding as of December 31, 2022 5,931,742 5.91 6.14 2,245 Options exercisable as of December 31, 2022 3,079,121 3.58 4.12 2,245 Options vested or expected to vest as of December 31, 2022 5,490,567 $ 5.68 5.95 2,245 The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s Class A common stock for those stock options that have exercise prices lower than the fair value of the Company’s Class A common stock. The total fair value of options vested during the years ended December 31, 2022 and 2021 was $ 2,082 and $ 813 , respectively. As of December 31, 2022, the total unrecognized stock compensation expense was $ 5,825 and was expected to be recognized over a weighted-average period of 2.61 years. Between 2010 and 2013, a former executive took several partial recourse notes totaling $ 635 to exercise his 675,990 shares of stock options. The notes were secured with these shares held by the former executive. When the loans were outstanding, the options were not considered exercised and were included within the options outstanding for accounting purposes. As of December 31, 2020, $ 334 of the principal balance of the partial recourse notes was outstanding and 195,278 shares were not considered outstanding for accounting purposes. In the three months ended March 31, 2021, the former executive repaid the remaining principal balance of the notes (see footnote “19. Related Parties Transactions”). The repayments were treated as the exercise price for the 195,278 shares of the options and were included in the consolidated statement of stockholders’ equity. After the partial recourse notes were paid off, all of the 675,990 shares used to secure the notes were considered outstanding for accounting purposes.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	15. Income Taxes The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2022, 2021, and 2020: Year Ended December 31, 2022 2021 2020 Income tax expense (benefit): Current tax expense (benefit) Federal $ 178 $ - $ ( 106 ) State 2,575 899 505 Foreign 17 ( 39 ) 19 Total current tax expense 2,770 860 418 Deferred tax expense (benefit) Federal 5,446 ( 30,506 ) 109 State ( 3,466 ) ( 1,470 ) - Foreign - - 3 Total deferred tax expense (benefit) 1,980 ( 31,976 ) 112 Total income tax expense (benefit) $ 4,750 $ ( 31,116 ) $ 530 On a periodic basis, the Company reassesses the valuation allowance on its deferred income tax assets, weighing positive and negative evidence to assess the recoverability of the deferred tax assets. In the fourth quarter of fiscal year 2021, the Company assessed the valuation allowance and considered positive evidence, including significant cumulative consolidated income over the three years ended December 31, 2021, revenue growth and expectations of future profitability, and negative evidence, including the impact of a negative change in the economic climate, significant risks and uncertainties in the business and restrictions on tax loss utilization in certain state jurisdictions. After assessing both the positive evidence and the negative evidence, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on its net deferred tax assets as of December 31, 2021, resulting in a benefit from income taxes of $ 48,252 . The Company maintained the same position that its net U.S. deferred tax assets did not require a valuation allowance as of December 31, 2022. As of December 31, 2022, the Company had available for the reduction of future years’ federal taxable income, net operating loss carry-forwards of approximately $ 44,390 , all of which can be carried forward indefinitely. The Company had state net operating loss carry-forwards of approximately $ 14,293 , expiring from the year ended December 31, 2031 through 2038. At December 31, 2022, the Company had available for the reduction of future years’ federal taxable income, research and development credits of approximately $ 443 expiring between December 31, 2027 and December 31, 2039. Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2022 and 2021 are as follows: December 31, 2022 2021 Net operating loss carryforwards Federal $ 9,327 $ 21,760 State 960 1,612 Foreign 16 16 Other 5,658 7,556 Capitalized R&D 8,849 - Stock-based compensation 1,453 676 Finance leases 126 632 Operating leases 13,164 12,918 Fixed assets 3,921 2,748 Net deferred tax assets before valuation allowance 43,474 47,918 Valuation allowance - - ROU assets ( 10,724 ) ( 12,273 ) Intangibles ( 2,736 ) ( 3,651 ) Net deferred tax assets $ 30,014 $ 31,994 The Company’s subsidiary in Switzerland is carrying a deferred tax asset of approximately $ 16 relating to a net operating loss carryover that is expected to be benefited in the next couple of years. The Company has not recorded withholding taxes on the undistributed earnings of its Swiss subsidiary because it is the Company’s intent to reinvest such earnings indefinitely. Ownership changes, as defined in the Internal Revenue Code, may limit the amount of net operating losses and research and development tax credit carryforwards that can be utilized annually to offset future taxable income. Subsequent ownership changes could further affect the limitation in future years. The Company completed an analysis in 2021 and determined that it had not experienced an ownership change during the periods 2001 through 2021. The differences between income taxes expected at the U.S. federal statutory income tax rate of 21 % and the reported consolidated income tax benefit (expense) are summarized as follows: December 31, 2022 2021 2020 U.S. federal statutory income tax rate 21.0 % 21.0 % 21.0 % Federal valuation allowance - % ( 70.6 ) % ( 28.9 ) % State valuation allowance - % ( 9.1 ) % ( 4.8 ) % Return to provision and other adjustments ( 1.6 ) % - - Prior period correction ( 8.5 ) % - - State and local income taxes 6.8 % 6.8 % 6.2 % Nondeductible expenses 1.3 % 0.8 % 6.0 % Executive compensation limited by 162(m) 3.1 % - - Foreign rate differential 0.1 % - - Uncertain tax position reserves 0.3 % 0.9 % 0.4 % Research and development credits 0.9 % 0.9 % 3.0 % Effective income tax rate 23.4 % ( 49.3 ) % 2.9 % The Company recognizes the tax benefit from an uncertain tax position only if it is more-likely-than-not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The amount of unrecognized tax benefits is $ 2,642 , $ 2,307 , and $ 2,870 , as of December 31, 2022, 2021, and 2020, respectively. A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below: Year Ended December 31, 2022 2021 2020 Gross balance at beginning of year $ 1,612 $ 2,123 $ 2,618 Additions based on tax positions related to the current period 206 153 111 Reductions for tax positions of prior years ( 186 ) ( 664 ) ( 606 ) Gross balance at end of year $ 1,632 $ 1,612 $ 2,123 The Company files income tax returns in the U.S. federal and state jurisdictions and Switzerland. With limited exceptions, the Company is no longer subject to federal, state, local or foreign examinations for years prior to December 31, 2018. However, carryforward attributes that were generated prior to December 31, 2018 may still be adjusted upon examination by state or local tax authorities if they either have been or will be used in a future period. The Company recognizes interest and penalty-related expenses in tax expenses. $ 404 and $ 330 of interest recorded for uncertain tax positions for the years ended December 31, 2022 and 2021, respectively, was classified in accrued expenses in the consolidated balance sheets. These amounts are not reflected in the reconciliation above.

Earnings (Loss) Per Share (EPS)

Earnings (Loss) Per Share (EPS)	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Earnings (Loss) per Share (EPS)	16. Earnings (Loss) per Share (EPS) Basic EPS is calculated by dividing net income (loss) by the weighted-average number of shares outstanding during the period. Diluted EPS is calculated by dividing net income (loss) by the weighted-average number of shares outstanding plus the dilutive effect, if any, of outstanding equity awards using the treasury stock method which includes consideration of unrecognized compensation expenses as additional proceeds. A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the Class A common stockholder s is as follows: Year Ended December 31, 2022 2021 2020 Numerator: Net Income $ 15,532 $ 94,202 $ 17,234 Denominator: Weighted average common shares outstanding —basic 130,070,231 128,331,022 107,737,936 Dilutive effect of restricted stock units 149,215 469,123 135,932 Dilutive effect of options 2,163,706 4,862,514 3,486,963 Weighted-average common shares outstanding—diluted 132,383,152 133,662,659 111,360,831 Earnings per share—basic $ 0.12 $ 0.73 $ 0.16 Earnings per share—diluted $ 0.12 $ 0.70 $ 0.15 For the year ended December 31, 2022, 2021, and 2020, outstanding stock-based awards of 3,445,191 , 994,168 and 1,792,085 , respectively, were excluded from the diluted EPS calculation as they were anti-dilutive.

Leases

Leases	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Leases	17. Leases The Company’s leases consist primarily of real estate, equipment and vehicle leases. The Company leases real estate for office, lab, warehouse and production space under noncancelable leases that expire at various dates through 2035, subject to the Company’s options to terminate or renew certain leases for an additional five to ten years . The Company leases vehicles under operating leases for certain employees and has fleet services agreements for service on these vehicles. The minimum lease term for each newly leased vehicle is 367 days with renewal options. The Company may terminate the vehicle lease after the minimum lease term upon thirty days’ prior notice. The Company also leases other equipment under noncancelable operating leases that expire at various dates through 2025. The Company determines if an arrangement is a lease at lease inception. The options to extend or terminate a lease are included in the lease terms when it is reasonably certain that the Company will exercise the options. Operating leases are included in operating lease right-of-use assets and operating lease obligations on the consolidated balance sheets. Finance lease right-of-use assets are included in property and equipment, net, and the related liabilities are included in finance lease obligations on the consolidated balance sheets. Right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities are recognized based on the present value of the fixed lease payments over the lease term at the commencement date. The right-of-use assets also include any initial direct costs incurred and lease payments made at or before the commencement date and are reduced by lease incentives. The Company uses its incremental borrowing rate as the discount rate to determine the present value of the lease payments for leases that do not have a readily determinable implicit discount rate. The Company’s incremental borrowing rate is the rate of interest that it would have to borrow on a collateralized basis over a similar term and amount in a similar economic environment. The Company determines the incremental borrowing rates for its leases by adjusting the risk-free interest rate with a credit risk premium corresponding to the Company’s credit rating. The Company records rent expense for its operating leases on a straight-line basis from the lease commencement date until the end of the lease term. The Company records finance lease cost as a combination of the depreciation expense for the right-of-use assets and interest expense for the outstanding lease liabilities using the discount rate discussed above. Variable lease payments are primarily related to the office and fleet leases which include but are not limited to taxes, insurance, common area maintenance and maintenance programs for leased vehicles. Variable lease payments are based on the occurrence or usage; therefore, they are not included as part of the initial right-of-use assets and liabilities calculation. On January 1, 2013, the Company entered into finance lease arrangements with 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC for office and laboratory space in Canton, Massachusetts. 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC are related parties as the owners of these entities are also directors, former directors and / or stockholders of the Company. In August 2021, the Company purchased the building (the “275 Dan Road Building”) under the lease with 275 Dan Road SPE, LLC for $ 6,013 and the lease was terminated. The Company recorded an asset of $4,943 to buildings within fixed asset, net in accordance with ASC 842-20-40-2 Purchase of the Underlying Asset to account for the purchase of the leased asset. Other than the lease with 275 Dan Road SPE, LLC which was terminated in August 2021, the remaining three leases were set to terminate on December 31, 2022 and each contained a renewal option for a five-year period with a rental rate at the greater of (i) rent for the last year of the prior term, or (ii) the then fair market value. The Company exercised the option to extend the leases for an additional five years in November 2021. It remeasured the lease assets and liabilities based on its best estimate of the market rental rate in the renewal period and reassessed the classification for these leases according to ASC 842-10-25-1 Lease Classification. As a result, these leases were reclassified from finance leases to operating leases . The related finance lease assets and liabilities were reclassified to operating lease right-of-use assets and operating lease obligations on the consolidated balance sheet as of December 31, 2021. In December 2022, the Company and the landlord finalized the market rental rate in the renewal period for these properties, resulting in an additional $ 8,060 to be recorded as variable lease expenses over the renewal period. The Company owes some accrued but unpaid lease obligations under the aforementioned leases as detailed in the section below. Effective April 1, 2019, the Company agreed to accrue interest on the accrued but unpaid lease obligations at an interest rate equal to the rate charged under the 2019 Credit Agreement. In connection with the purchase of the 275 Dan Road Building in August 2021, the Company paid 50 % of the accrued but unpaid lease obligations associated with this building and the accrued interest thereof. The remaining balance for this building was paid in five quarterly installments through January 3, 2023. The accrued but unpaid lease obligations as well as the related interest accru als are shown below. December 31, 2022 2021 Principal portion of rent in arrears $ 5,779 $ 7,246 Unpaid operating and common area maintenance costs - 558 Total accrued but unpaid lease obligations $ 5,779 $ 7,804 Accrued interest on accrued but unpaid lease obligations $ 1,956 $ 1,938 The principal portion of rent in arrears was included in the short-term portion of operating lease obligations other than the balance related to the 275 Dan Road Building that was included in accrued expenses and other current liabilities on the consolidated balance sheets as of December 31, 2022 and 2021. The unpaid operating and common area maintenance costs, and the accrued interest on the accrued but unpaid lease obligations were included in accrued expenses and other current liabilities on the consolidated balance sheets as of December 31, 2022 and 2021. The components of lease cos t were as follows: Classification Year Ended Year Ended Finance lease Amortization of right-of-use assets COGS and SG&A $ 213 $ 1,707 Interest on lease liabilities Interest Expense 7 980 Total Finance lease cost 220 2,687 Operating lease cost COGS, R&D, SG&A 9,570 7,066 Short-term lease cost COGS, R&D, SG&A 2,951 2,869 Variable lease cost COGS, R&D, SG&A 5,082 4,808 Total lease cost $ 17,823 $ 17,430 Supplemental balance sheet information r elated to finance leases was as follows: December 31, December 31, 2022 2021 Property and equipment, gross $ 1,174 $ 1,174 Accumulated depreciation ( 1,174 ) ( 961 ) Property and equipment, net $ - $ 213 Current portion of finance lease obligations $ - $ 200 Finance lease long-term obligations - - Total finance lease liabilities $ - $ 200 Supplemental cash flow information relate d to leases was as follows: Year Ended Year Ended Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 9,273 $ 7,276 Operating cash flows for finance leases $ 7 $ 1,427 Financing cash flows for finance leases $ 200 $ 2,630 Right-of-use assets obtained in exchange for lease obligations Operating leases $ 1,350 $ 53,793 Finance leases $ - $ - December 31, December 31, 2022 2021 Weighted-average remaining lease term Finance leases - 0.45 Operating leases 7.54 8.22 December 31, December 31, 2022 2021 Weighted-average discount rate Finance leases - 11.30 % Operating leases 4.61 % 4.51 % As of December 31, 2022, the maturities of lease liabilities were as follows: Operating leases 2023 $ 13,747 2024 7,366 2025 7,578 2026 7,489 2027 8,002 Thereafter 18,613 Total lease payments 62,795 Less: interest ( 9,773 ) Total lease liabilities $ 53,022

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure	18. Commitments and Contingencies Royalties The Company entered into a license agreement with a university for certain patent rights related to the development, use and production of one of its advanced wound care products. Under this agreement, the Company incurred a royalty based on a percentage of net product sales, for the use of these patents until the patents expired, which was in November 2006. Accrued royalties totaled $ 1,187 as of December 31, 2022 and 2021, respectively, and were classified as part of accrued expenses and other current liabilities on the Company’s consolidated balance sheets. There was no royalty expense incurred during the years ended December 31, 2022, 2021, and 2020, related to this agreement. In October 2017, the Company entered into a license agreement with a third party. Under the license agreement, the Company is required to pay royalties based on a percentage of net sales of the licensed product that occur, after December 31, 2017, through the expiration of the underlying patent in October 2026, subject to minimum royalty payment provisions. The Company recorded royalty expense of $ 7,279 , $ 5,929 , and $ 4,370 , during the years ended December 31, 2022, 2021, and 2020, respectively, within selling, general and administrative expenses on the consolidated statements of operations. As part of the NuTech Medical acquisition, the Company inherited certain product development and consulting agreements for ongoing consulting services and royalty payments based on a percentage of net sales on certain products over a period of 15 years from the execution of the agreements. These product development and consulting agreements were canceled in January 2020 for total consideration of $ 1,950 which was paid on February 14, 2020. The $ 1,950 cancellation fee was recorded within selling, general and administrative expenses on the consolidated statement of operations for the year ended December 31, 2020. Legal Matters In conducting its activities, the Company, from time to time, is subject to various claims and also has claims against others. In management’s opinion, the ultimate resolution of such claims would not have a material effect on the financial position, operating results or cash flows of the Company. The Company accrues for these claims when amounts due are probable and estimable. The Company accrued $ 150 as of December 31, 2022 and 2021 for certain pending lawsuits. The purchase price for NuTech Medical acquired in 2017 included $ 7,500 deferred acquisition consideration of which the Company paid $ 2,500 in 2017. The remaining $ 5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical was previously in dispute. In February 2020, the Company entered into a settlement agreement with the sellers of NuTech Medical and settled the dispute for $ 4,000 of which, $ 2,000 was paid immediately on February 24, 2020 and the remaining $ 2,000 was paid in four quarterly installments of $ 500 each through March 31, 2021. In addition, the Company assumed from the sellers of NuTech Medical the payment responsibilities related to a legacy lawsuit existing at the acquisition date of NuTech Medical. The assumed legacy lawsuit was settled in October 2020. In connection with the settlement of the deferred acquisition consideration dispute and the legacy lawsuit, the Company recorded a gain of $ 2,246 for the year ended December 31, 2020. The gain was included as a component of other expense, net, on the consolidated statement of operations.

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2022
Related Party Transactions [Abstract]
Related Party Transactions	19. Related Party Transactions Lease obligations to affiliates, including accrued but unpaid lease obligations, purchase of an asset under a finance lease with an affiliate, and renewal of leases with affiliates are further described in Note “17. Leases”. In 2010, the Company’s Board of Directors approved a loan program that permitted the Company to make loans to three executives of the Company (the “Employer Loans”) to (i) provide them with liquidity (“Liquidity Loans”) and (ii) fund the exercise of vested stock options (“Option Loans”). Two of the executives left the Company in 2014. The Employer Loans matured with all principal and accrued interest due on the tenth anniversary of the issuance date of each subject loan. Interest on the Employer Loans was at various rates ranging from 2.30 %— 3.86 % per annum, compounded annually. The Employer Loans were secured by shares of the Company’s Class A common stock held by the former executives. With respect to the Liquidity Loans, the Company had no personal recourse against the borrowers beyond the pledged shares. As of December 31, 2020, Liquidity Loans and Option Loans to one former executive were outstanding with an aggregate principal balance of $ 100 and $ 334 , respectively. During the three months ended March 31, 2021, this former executive paid off the outstanding principal balance of his Employer Loans and the related interest receivable. As a result, the Company recorded $ 179 as a recovery of the previously reserved related party receivables within selling, general and administrative expenses on the consolidated statement of operations for the year ended December 31, 2021. The $ 334 of the repaid principal balance of the Option Loans was recorded to equity. See footnote “14. Share-Based Compensation”.

Employee Benefit Plan

Employee Benefit Plan	12 Months Ended
	Dec. 31, 2022
Retirement Benefits [Abstract]
Employee Benefit Plan	20. Employee Benefit Plan The Company maintains a 401(k) Savings Plan (the “Plan”) for the U.S. employees. Under the Plan, eligible employees may contribute, subject to statutory limitations, a percentage of their salary to the Plan. Contributions made by the Company are made at the discretion of the Board of Directors and vest immediately. During the years ended December 31, 2022, 2021, and 2020, the Company made employer contributions of $ 6,601 , $ 3,092 , and $ 2,731 , respectively.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2022
Subsequent Events [Abstract]
Subsequent Events	21. Subsequent Events The Company has performed an evaluation of subsequent events through the time of filing this Annual Report on Form 10-K with the SEC. On February 3, 2023, the Company announced a reduction in force in response to macroeconomic conditions. The reduction in force reduced the Company’s headcount by 70 employees, or approximately 7 % of all employees. The Company expects to incur a total charge of approximately $ 1.7 million in the first quarter of 2023, primarily consisting of severance payments. In the first quarter of 2023, options to purc hase 3,556,282 shares of common stock and 2,868,531 shares of restri cted stock units were granted to our Board of Directors and executives. The majority of these options and restricted stock units will vest over four years . At the time of the submission of this Annual Report on Form 10-K, the Company's products are subject to the Infrastructure Investment and Jobs Act and rebate obligation that took effect on January 1, 2023. Consequently, the Company may owe rebates to the federal government prospectively, on Apligraf, Dermagraft (when marketed), and PuraPly products and possibly other products if more than a certain percentage of a single-use product is not administered to a patient and is discarded by providers.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Restatement To Previously Issued Financial Statements	Restatement to Previously Issued Financial Statements In August 2022, the Company reached an agreement with a Group Purchasing Organization (“GPO”) to settle previously disputed GPO fees for $ 3,300 . The Company identified that part of the settlement fee should have been accrued as of March 31, 2022 and December 31, 2021. This error resulted in an overstatement of revenue and understatement of accrued expenses and other current liabilities and accumulated deficit in the financial statements included in the Company’s quarterly reports on Form 10-Q and the Company’s Annual Report previously filed with the SEC. The Company assessed the materiality of this error on prior period financial statements in accordance with the SEC Staff Accounting Bulletin Number 99, Materiality, and ASC 250-10, Accounting Changes and Error Corrections. The Company determined that this error was not material to the financial statements of any prior annual or interim period. To correct the immaterial misstatement, the Company restated its previously issued financial statements as follows: March 31, 2022 December 31, 2021 CONSOLIDATED BALANCE SHEETS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Accrued expenses and other current liabilities $ 32,419 $ 1,700 $ 34,119 $ 36,589 $ 700 $ 37,289 Total current liabilities $ 76,792 $ 1,700 $ 78,492 $ 82,005 $ 700 $ 82,705 Total liabilities $ 193,044 $ 1,700 $ 194,744 $ 201,224 $ 700 $ 201,924 Accumulated deficit $ ( 60,046 ) $ ( 1,700 ) $ ( 61,746 ) $ ( 60,133 ) $ ( 700 ) $ ( 60,833 ) Total stockholders’ equity $ 243,228 $ ( 1,700 ) $ 241,528 $ 242,035 $ ( 700 ) $ 241,335 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF OPERATIONS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Gross profit $ 73,037 $ ( 1,000 ) $ 72,037 $ 353,860 $ ( 700 ) $ 353,160 Income from operations $ 872 $ ( 1,000 ) $ ( 128 ) $ 72,918 $ ( 700 ) $ 72,218 Net income before income taxes $ 132 $ ( 1,000 ) $ ( 868 ) $ 63,786 $ ( 700 ) $ 63,086 Net income $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net income / (loss) $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Changes in operating assets and liabilities: Accrued expenses and other current liabilities $ ( 4,828 ) $ 1,000 $ ( 3,828 ) $ 8,654 $ 700 $ 9,354 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Revenue by Product Category: As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Advanced Wound Care $ 90,950 $ ( 860 ) $ 90,090 $ 430,839 $ ( 602 ) $ 430,237 Surgical & Sports Medicine $ 7,167 $ ( 140 ) $ 7,027 $ 37,220 $ ( 98 ) $ 37,122 Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Miscellaneous Items As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated GPO fees $ 619 $ 1,000 $ 1,619 $ 2,963 $ 700 $ 3,663 PuraPly revenue $ 53,300 $ ( 500 ) $ 52,800 $ 198,400 $ ( 350 ) $ 198,050
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting periods. In preparing the consolidated financial statements, the estimates and assumptions that management considers to be significant and that present the greatest amount of uncertainty include revenue recognition; sales returns and credit losses; inventory reserve; recognition and measurement of current and deferred income tax assets and liabilities; the assessment of recoverability of long-lived assets, assessing impairment of goodwill; valuation of assets and liabilities that use unobservable inputs, and the valuation and recognition of stock-based compensation. Actual results and outcomes may differ significantly from those estimates and assumptions.
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc., and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Segment Reporting	Segment Reporting Operating segments are defined as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker, or decision-making group, in making decisions on how to allocate resources and assess performance for the organization. The Company’s chief operating decision maker is the Chief Executive Officer. The Company’s chief operating decision maker reviews consolidated operating results to make decisions about allocating resources and assessing performance for the entire Company. Accordingly, the Company has determined that it has a single operating segment—regenerative medicine. The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The Company’s portfolio includes regenerative medicine products in various stages, ranging from preclinical to late stage development, and commercialized advanced wound care and surgical and sports medicine products which support healing across a wide variety of wound types at many different types of facilities.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company primarily maintains its cash in bank deposit accounts in the United States which, at times, may exceed the federally insured limits. The Company has not experienced losses in such accounts and believes it is not exposed to significant credit risk on cash. The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents.
Restricted Cash	Restricted Cash The Company had restricted cash of $ 812 and $ 599 as of December 31, 2022 and 2021, respectivel y. Restricted cash represents employee deposits in connection with the Company’s health benefit plan.
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable are stated at invoice value less estimated allowances for doubtful accounts. The Company continually monitors customer payments and maintains a reserve for estimated losses resulting from its customers’ inability to make required payments. The Company considers factors when estimating the allowance for doubtful accounts such as historical experience, credit quality, age of the accounts receivable balances, geography-related risks and economic conditions that may affect a customer’s ability to pay. In cases where there are circumstances that may impair a specific customer’s ability to meet its financial obligations, a specific allowance is recorded against amounts due, thereby reducing the net recognized receivable to the amount reasonably believed to be collectible. Accounts receivables are written off when deemed uncollectible. Recoveries of accounts receivables previously written off are recorded when received.
Inventories	Inventories Inventories are stated at the lower of cost (determined under the first-in first-out method) or net realizable value. Work in process and finished goods include materials, labor and allocated overhead. Inventories also include cell banks and the cost of tests mandated by regulatory agencies of the materials to qualify them for production. The Company regularly reviews inventory quantities on hand and records a provision to write down excess and obsolete inventory to its estimated net realizable value based upon management’s assumptions of future material usage, yields and obsolescence, which are a result of future demand and market conditions and the effective life of certain inventory items. The Company also tests other components of its inventory for future growth projections. The Company determines the average yield of the component and compares it to projected revenue to ensure it is properly reserved.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost and depreciated over the estimated useful lives of the respective assets on a straight-line basis. As of December 31, 2022 and 2021, the Company’s property and equipment consisted of leasehold improvements, building, furniture and computers, and equipment. Property and equipment’s estimated useful lives are as follows: Leasehold improvements Lesser of the life of the lease or the economic life of the asset Building 30 years Furniture and computers 3 - 5 years Equipment 5 - 10 years Upon retirement or sale, the cost of assets disposed of, and the related accumulated depreciation are removed from the accounts and any resulting gain or loss is included in the consolidated statement of operations. Expenditures for repairs and maintenance are charged to expense as incurred. Expenditures for major improvements that extend the useful lives of the related asset are capitalized and depreciated over their remaining estimated useful lives. Construction in progress costs are capitalized when incurred until the assets are placed in service, at which time the costs will be transferred to the related property and equipment, and depreciated over their respective useful lives.
Goodwill	Goodwill Goodwill represents the excess of the purchase price of an acquired business over the fair value of the identifiable assets acquired and liabilities assumed. Goodwill is not amortized, but is tested for impairment at least annually (as of December 31), or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. Circumstances that could trigger an impairment test include, but are not limited to, a significant adverse change in the business climate or legal factors, an adverse action or assessment by a regulator, or unanticipated competition. The Company operates as one segment, which is considered to be the sole reporting unit, and therefore goodwill is tested for impairment at the consolidated level. In accordance with ASC Topic 350, Intangibles - Goodwill and Other, the Company may first assess qualitative factors to determine whether it is necessary to perform the quantitative goodwill impairment test. If after assessing the totality of events or circumstances, the Company determines that it is more likely than not (i.e. greater than 50% likelihood) that the fair value of the reporting unit is less than its carrying amount, then the quantitative test is required. Otherwise, no further testing is required. Alternatively, the Company can bypass the qualitative assessment and proceed directly to the quantitative test. The quantitative goodwill impairment test requires the Company to estimate and compare the fair value of the reporting unit with its carrying value. If the fair value of the reporting unit exceeds the carrying value of the net assets, goodwill is not impaired. If the fair value of the reporting unit is less than the carrying value, the difference is recorded as an impairment loss up to the amount of goodwill. At December 31, 2022, we elected to perform a quantitative analysis directly. We used the Company’s market capitalization to approximate the fair value of the reporting unit. The fair value exceeded the carrying value and no impairment was recorded. There was no impairment of goodwill recorded during the years ended December 31, 2022 , 2021, or 2020.
Intangible Assets Subject to Amortization	Intangible Assets Subject to Amortization Intangible assets include intellectual property either owned by the Company or for which the Company has a license. Intangible assets acquired in a business combination are recognized at fair value using generally accepted valuation methods deemed appropriate for the type of intangible asset acquired. Intangible assets are reported net of accumulated amortization, separately from goodwill. Intangible assets with finite lives are amortized over their estimated useful lives. Intangible assets include developed technology and patents, trade names, trademarks, customer relationships and non-compete agreements obtained through business acquisitions. Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated metho d based on the following estimated useful lives: Trade names and trademarks 1 - 12 years Developed technology 6 - 12 years Customer relationships 10 years Non-compete agreements 5 years
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets Long-lived assets consist primarily of property and equipment. The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Factors that the Company considers in deciding when to perform an impairment review include, but not limited to, significant underperformance of the business in relation to expectations, significant negative industry or economic trends and significant changes or planned changes in the use of the assets. When such an event occurs, the Company determines whether there has been impairment by comparing the anticipated undiscounted future net cash flows to the related asset group’s carrying value. If an asset is determined to be impaired, the asset is written down to fair value, which is determined based either on discounted cash flows or appraised value, depending on the nature of the asset. The Company did not record any impairment of long-lived assets during the years ended December 31, 2022 , 2021, or 2020.
Revenue Recognition	Revenue Recognition Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to this single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideration Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and GPO fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as a reduction of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or changes in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction of revenue and the establishment of a liability that is included in accrued expenses in the accompanying consolidated balance sheets in the period the related product revenue is recognized. GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of the product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue based on the substance of the relationship of all parties involved in the transaction. For the years ended December 31, 2022 , 2021, and 2020, the Company recorded GPO fees of $ 6,654 , $ 3,663 , and $ 3,572 , respectively, as a direct reduction of revenue. Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a contract has a significant financing component if the expectation at contract inception is such that the period between payment by the customer and the transfer of the promised products to the customer will be one year or less, which is the case with substantially all customers. Applying the practical expedient in ASC 340-40-25-4, the Company recognizes the incremental costs of obtaining contracts as an expense when incurred if the amortization period of the assets that the Company otherwise would have recognized is one year or less. These costs are included in selling, general, and administrative expenses. Applying the practical expedient in ASC 606-10-25-18B, the Company accounts for shipping and handling activities related to contracts with customers as costs to fulfill the promise to transfer the associated products. The Company records the related costs as part of the cost of goods sold. Disaggregation of Revenue The following table sets forth revenu e by product category: Year Ended December 31, 2022 2021 2020 Advanced Wound Care revenue $ 422,231 $ 430,237 $ 294,624 Surgical and Sports Medicine revenue 28,662 37,122 43,674 Total revenue $ 450,893 $ 467,359 $ 338,298 For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue.
Stock-Based Compensation	Stock-Based Compensation The Company measures stock-based awards granted based on the fair value of the awards on the date of grant and recognizes compensation expense for those awards over the requisite service period, which is generally the vesting period of the respective award. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Generally, the Company issues stock-based awards with only service-based vesting conditions and records the expense for these awards using the straight-line method. The Company has not issued any stock-based awards with performance-based vesting conditions. The Company recognizes stock-based compensation expense within selling, general and administrative expenses in the consolidated statement of operations for all share-based payments based upon the estimated grant-date fair value for the awards expected to ultimately vest. The fair value of each restricted stock unit grant is based on the fair market value of the Company’s Class A common stock on the date of grant. The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option-pricing model. The Company has been a public company for a short period of time, has limited public float and lacks company-specific historical and implied volatility information for its Class A common stock. Therefore, it estimates its expected stock price volatility based on the historical volatility of publicly traded peer companies and expects to continue to do so until such time as it has adequate historical data regarding the volatility of its own traded stock price. The expected term of the Company’s stock options has been determined utilizing the “simplified” method for awards that qualify as “plain-vanilla” options. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends on its Class A common stock and does not expect to pay any cash dividends in the foreseeable future.
Advertising	Advertising Advertising costs are expensed as incurred and are included in selling, general and administrative expenses in the consolidated statements of operations. Advertising costs were approximately $ 4,812 , $ 5,522 , and $ 2,722 , for the years ended December 31, 2022 , 2021, and 2020, respectively.
Research and Development Costs	Research and Development Costs Research and development expenses include personnel costs for the Company’s research and development personnel, expenses related to improvements in manufacturing processes, enhancements to the Company’s currently available products, and additional investments in the product and platform development pipeline. Research and development expenses also include expenses for clinical trials. The Company expenses research and development costs as incurred.
Foreign Currency	Foreign Currency The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting from re-measurement of assets and liabilities held in foreign currencies and transactions settled in a currency other than the functional currency are included separately as non-operating income or expense in the consolidated statements of operations as a component of other expense, net. The foreign currency amounts recorded for all periods presented were insignificant.
Valuation of Contingent Purchase Earnout	Valuation of Contingent Purchase Earnout In connection with the acquisition of CPN, the Company recognized a non-current liability for the fair value of the contingent consideration (the “Earnout”) at the time of the acquisition in 2020. The Earnout liability was classified as a Level 3 measurement for which fair value was derived from inputs that were unobservable and significant to the overall fair value measurement. The fair value of such Earnout liability was estimated using a Monte Carlo simulation model that utilized key assumptions including forecasted revenues and volatilities of the underlying financial metrics during the Earnout period. The Company assessed the fair value of the Earnout liability at each reporting period. Any subsequent changes in the estimated fair value of the liability were reflected in selling, general and administrative expenses until the liability was settled.
Income Taxes	Income Taxes The Company accounts for income taxes using the asset and liability method which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the consolidated financial statements or in the Company’s tax returns. Deferred tax assets and liabilities are determined on the basis of the differences between the consolidated financial statement and the tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company quarterly assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of the deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. In determining whether a valuation allowance for deferred tax assets is necessary, the Company analyzes both positive and negative evidence related to the realization of deferred tax assets, including projected future taxable income, recent financial results and estimates of future reversals of deferred tax assets and liabilities. In addition, the Company considers whether it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. In consideration of the factors discussed above, in the fourth quarter of 2021, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on the net U.S. deferred tax assets as of December 31, 2021, resulting in a benefit of $ 48.3 million in income taxes. The Company maintained the same position that its net U.S. deferred tax assets did not require a valuation allowance as of December 31, 2022. See footnote “15. Income Taxes.” The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more-likely-than-not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the consolidated financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties.
Fair Value of Financial Instruments	Fair Value of Financial Instruments Certain assets and liabilities of the Company are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The carrying values of accounts receivable, inventory, prepaid expenses and other current assets, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The fair value of the Earnout liability was determined according to Level 3 inputs in the fair value hierarchy described above (see footnote “4. Fair Value Measurement of Financial Instruments”). The carrying values of outstanding borrowings under the Company’s debt arrangements (see footnote “12. Long-Term Debt Obligations”) approximate their fair values as determined based on a discounted c ash flow model, which represents a Level 3 measurement.
Earnings (Loss) per Share (EPS)	Earnings (Loss) per Share (EPS) The Company determines earnings (loss) per share in accordance with the authoritative guidance in ASC Topic 260, Earnings Per Share . The Company has one class of common stock (Class A common stock) for purposes of the EPS calculation and therefore computes basic EPS by dividing net income (loss) by the weighted average number of common shares outstanding for the applicable period. Diluted EPS is computed in the same manner as basic EPS, except that the number of shares is computed by giving effect to all potential dilutive common shares. For purpose of this calculation, outstanding stock options, and unvested restricted stock are considered potential dilutive common shares.
Emerging Growth Company	Emerging Growth Company Before December 31, 2021, the Company was an “emerging growth company,” as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. Section 107 of the JOBS Act provides that an emerging growth company can take advantage of the extended transition period afforded by the JOBS Act for the implementation of new or revised accounting standards. The Company elected to use the extended transition period for complying with new or revised accounting standards (such as ASU 2016-02, Leases (Topic 842)) and, as a result of this election, the Company’s financial statements prior to 2021 may not be comparable to companies that comply with public company effective dates. Effective December 31, 2021, the Company is no longer an emerging growth company.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting (“ASU 2020-04”). ASU 2020-04 provides temporary optional expedients and exceptions to the US GAAP guidance on contract modifications and hedge accounting to ease the financial reporting burdens related to the expected market transition from the London Interbank Offered Rate (LIBOR) and other interbank offered rates to alternative reference rates. In January 2021, the FASB issued ASU No. 2021-01, Reference Rate Reform (Topic 848): Scope (“ASU 2021-01”), to clarify certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting to apply to derivatives that are affected by the discounting transition. Both ASU 2020-04 and ASU 2021-01 are effective upon issuance through December 31, 2022. In December 2022, the Company executed an amendment to its debt agreement, replacing LIBOR with the secured overnight financing rate (“SOFR”). The Company utilized the relief provided in these ASUs. As the amendment did not affect the amount or timing of the contractual cash flows and the contemporaneous modifications to the other terms were related to the reference rate reform, the amendment was not substantial in accordance with ASC 848-20-35-8 . Therefore, the amendment did not impact the Company’s consolidated financial statements.
Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). Subsequent to the issuance of ASU 2016-13, the FASB has issued the following updates: ASU 2018-19, Codification Improvements to Topic 326, Financial Instruments- Credit Losses , ASU 2019-04, Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815, Derivatives and Hedging , and Topic 825 , Financial Instruments , ASU 2019-05, Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief and ASU 2019-11, Codification Improvements to Topic 326 , Financial Instruments—Credit Losses . The objective of ASU 2016-13 and all the related updates is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The amendments in this ASU replace the incurred loss impairment methodology in current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. ASU 2016-13 and the related updates are effective for fiscal years, and interim periods within those years, beginning after December 15, 2019 for public business entities excluding entities eligible to be smaller reporting companies and for fiscal years, and interim periods within those years, beginning after December 15, 2022 for all other entities. Early adoption is permitted. As the Company was a smaller reporting company when the standard was issued, the Company took advantage of the extended transition period and will adopt this standard and the related improvements on January 1, 2023 by recognizing a cumulative-effect adjustment to retained earnings. The Company has finished evaluating the effects of adopting ASU 2016-13 and the related improvements and has determined that there will be an immaterial impact on the Company’s consolidated financial statements.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Schedule of Restated to Previously Issued Financial Statements to Correct The Misstatements	To correct the immaterial misstatement, the Company restated its previously issued financial statements as follows: March 31, 2022 December 31, 2021 CONSOLIDATED BALANCE SHEETS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Accrued expenses and other current liabilities $ 32,419 $ 1,700 $ 34,119 $ 36,589 $ 700 $ 37,289 Total current liabilities $ 76,792 $ 1,700 $ 78,492 $ 82,005 $ 700 $ 82,705 Total liabilities $ 193,044 $ 1,700 $ 194,744 $ 201,224 $ 700 $ 201,924 Accumulated deficit $ ( 60,046 ) $ ( 1,700 ) $ ( 61,746 ) $ ( 60,133 ) $ ( 700 ) $ ( 60,833 ) Total stockholders’ equity $ 243,228 $ ( 1,700 ) $ 241,528 $ 242,035 $ ( 700 ) $ 241,335 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF OPERATIONS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Gross profit $ 73,037 $ ( 1,000 ) $ 72,037 $ 353,860 $ ( 700 ) $ 353,160 Income from operations $ 872 $ ( 1,000 ) $ ( 128 ) $ 72,918 $ ( 700 ) $ 72,218 Net income before income taxes $ 132 $ ( 1,000 ) $ ( 868 ) $ 63,786 $ ( 700 ) $ 63,086 Net income $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Three Months Ended March 31, 2022 Year Ended December 31, 2021 CONSOLIDATED STATEMENTS OF CASH FLOWS As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Net income / (loss) $ 87 $ ( 1,000 ) $ ( 913 ) $ 94,902 $ ( 700 ) $ 94,202 Changes in operating assets and liabilities: Accrued expenses and other current liabilities $ ( 4,828 ) $ 1,000 $ ( 3,828 ) $ 8,654 $ 700 $ 9,354 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Revenue by Product Category: As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated Advanced Wound Care $ 90,950 $ ( 860 ) $ 90,090 $ 430,839 $ ( 602 ) $ 430,237 Surgical & Sports Medicine $ 7,167 $ ( 140 ) $ 7,027 $ 37,220 $ ( 98 ) $ 37,122 Net revenue $ 98,117 $ ( 1,000 ) $ 97,117 $ 468,059 $ ( 700 ) $ 467,359 Three Months Ended March 31, 2022 Year Ended December 31, 2021 Miscellaneous Items As Previously Reported Adjustments As Restated As Previously Reported Adjustments As Restated GPO fees $ 619 $ 1,000 $ 1,619 $ 2,963 $ 700 $ 3,663 PuraPly revenue $ 53,300 $ ( 500 ) $ 52,800 $ 198,400 $ ( 350 ) $ 198,050
Summary of Estimated Useful Lives of Property Plant and Equipment	Leasehold improvements Lesser of the life of the lease or the economic life of the asset Building 30 years Furniture and computers 3 - 5 years Equipment 5 - 10 years
Schedule of Finite-Lived Intangible Assets	Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated metho d based on the following estimated useful lives: Trade names and trademarks 1 - 12 years Developed technology 6 - 12 years Customer relationships 10 years Non-compete agreements 5 years
Schedule of Revenue by Product Category	The following table sets forth revenu e by product category: Year Ended December 31, 2022 2021 2020 Advanced Wound Care revenue $ 422,231 $ 430,237 $ 294,624 Surgical and Sports Medicine revenue 28,662 37,122 43,674 Total revenue $ 450,893 $ 467,359 $ 338,298

Fair Value Measurement of Fin_2

Fair Value Measurement of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Summary of Fair Value of Earnout liability	The following table provides a roll-forward of the fair value of the Company’s Earnout liability, for which fair value was determined using Level 3 inputs until the end of the Earnout Period on June 30, 2022. Earnout liability Balance as of December 31, 2019 $ - Acquisition Date fair value 3,782 Change in fair value 203 Balance as of December 31, 2020 3,985 Change in fair value ( 3,985 ) Balance as of December 31, 2021 - Change in fair value - Balance as of June 30, 2022 $ -

Accounts receivable, net (Table

Accounts receivable, net (Tables)	12 Months Ended
	Dec. 31, 2022
Receivables [Abstract]
Schedule of accounts receivable	Accounts receivab le consisted of the following: December 31, 2022 2021 Accounts receivable $ 95,812 $ 87,613 Less - allowance for doubtful accounts ( 6,362 ) ( 5,153 ) $ 89,450 $ 82,460
Schedule of allowance for doubtful accounts	The Company’s allowance for doubtful accounts was co mprised of the following: Balance as of December 31, 2020 $ 2,669 Additions 2,999 Write-offs ( 515 ) Balance as of December 31, 2021 $ 5,153 Additions 1,781 Write-offs ( 572 ) Balance as of December 31, 2022 $ 6,362

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2022
Inventory Disclosure [Abstract]
Schedule of Inventory, Current	Inventories, net of related reserves for excess and obsolescence, consisted of the following: December 31, 2022 2021 Raw materials $ 12,282 $ 9,023 Work in process 1,022 991 Finished goods 11,479 15,008 $ 24,783 $ 25,022

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Payables and Accruals [Abstract]
Schedule of prepaid expenses and other current assets	Prepaid expenses and other current assets co nsisted of the following: December 31, 2022 2021 Subscriptions $ 4,211 $ 2,745 Conferences and marketing expenses 106 538 Deposits 635 1,216 Insurance 54 358 Other 80 112 $ 5,086 $ 4,969

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	12 Months Ended
	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and equipment consiste d of the following: December 31, 2022 2021 Leasehold improvements $ 37,607 $ 30,531 Building 4,943 4,943 Furniture, computers and equipment 57,147 53,959 99,697 89,433 Accumulated depreciation ( 62,798 ) ( 57,729 ) Construction in progress 65,564 47,456 $ 102,463 $ 79,160

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-Lived Intangible Assets	Identifiable intangible assets consisted of the following a s of December 31, 2022: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ ( 21,164 ) $ 11,456 Trade names and trademarks 2,080 ( 1,393 ) 687 Customer relationship 10,690 ( 2,450 ) 8,240 Independent sales agency network 4,500 ( 4,500 ) - Patent 7,623 ( 7,623 ) - Non-compete agreements 1,010 ( 604 ) 406 Total $ 58,523 $ ( 37,734 ) $ 20,789 Identifiable intangible assets consisted of the following as of December 31, 2021: Original Accumulated Net Book Cost Amortization Value Developed technology $ 32,620 $ ( 17,709 ) $ 14,911 Trade names and trademarks 2,080 ( 1,183 ) 897 Customer relationship 10,690 ( 1,381 ) 9,309 Independent sales agency network 4,500 ( 4,500 ) - Patent 7,623 ( 7,623 ) - Non-compete agreements 1,010 ( 454 ) 556 Total $ 58,523 $ ( 32,850 ) $ 25,673
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	Estimated future annual amortization expense related to these in tangible assets is as follows: 2023 $ 4,918 2024 3,403 2025 3,323 2026 3,043 2027 2,283 Thereafter 3,819 Total $ 20,789

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	12 Months Ended
	Dec. 31, 2022
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Liabilities	Accrued expenses and other current liabilities consisted of the following: December 31, 2022 2021 Personnel costs $ 17,113 $ 26,865 Royalties 3,320 3,458 Accrued but unpaid lease obligations and interest 2,463 3,963 Accrued settlement fee - 700 Accrued taxes 2,625 1,160 Other 926 1,143 $ 26,447 $ 37,289

Restructuring (Tables)

Restructuring (Tables)	12 Months Ended
	Dec. 31, 2022
Restructuring and Related Activities [Abstract]
Summary of liability related to the restructuring activities	The following table provides a roll-forward of the restructuring liability. Employee Other Total Liability balance as of December 31, 2019 $ - $ - $ - Expenses 618 - 618 Cash distributions - - - Liability balance as of December 31, 2020 618 - 618 Expenses 3,513 1,191 4,704 Cash distributions ( 1,614 ) ( 540 ) ( 2,154 ) Liability balance as of December 31, 2021 2,517 651 3,168 Expenses 1,557 711 2,268 Cash distributions ( 3,064 ) ( 1,180 ) ( 4,244 ) Liability balance as of December 31, 2022 $ 1,010 $ 182 $ 1,192

Long-Term Debt Obligations (Tab

Long-Term Debt Obligations (Tables)	12 Months Ended
	Dec. 31, 2022
Long-Term Debt, Unclassified [Abstract]
Schedule of long-term debt obligations	December 31, 2022 2021 Line of credit $ - $ - Term loan 71,250 74,062 Less debt discount and debt issuance cost ( 481 ) ( 637 ) Term loan, net of debt discount and debt issuance cost $ 70,769 $ 73,425
Schedule of future payments of term loan facility	Future payments of the 2021 Credit Agreement, as of December 31, 2022, are as follows for th e calendar years ending December 31: 2023 $ 4,687 2024 5,625 2025 6,563 2026 54,375 Total $ 71,250

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2022
Equity [Abstract]
Schedule Of Common Stock Shares Reserved For Future Issuance	At December 31, 2022 and 2021, the Company reserved the following shares of Class A common stoc k for future issuance: December 31, 2022 2021 Shares reserved for issuance for outstanding options 5,931,742 6,596,969 Shares reserved for issuance for outstanding restricted stock units 1,381,500 764,871 Shares reserved for issuance for future grants 11,394,962 5,644,691 Total shares of authorized common stock reserved for future issuance 18,708,204 13,006,531

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Summary of Unvested Restricted Stock Units	The activity of restricted stock units is set forth below: Weighted Average Number Grant Date of Shares Fair Value Unvested at December 31, 2021 764,871 $ 7.52 Granted 979,257 7.56 Vested ( 249,106 ) 7.34 Canceled/Forfeited ( 113,522 ) 7.00 Unvested at December 31, 2022 1,381,500 $ 7.62
Schedule of Fair Value of Stock Options Granted to Employees and Directors	Year Ended December 31, 2022 2021 Risk-free interest rate 1.92 % 0.83 % Expected term (in years) 6.25 6.22 Expected volatility 50.66 % 39.31 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 8.03 $ 13.57 Underlying stock price $ 7.87 $ 13.57
Summary of Stock Option Activity	The following table summarizes the Company’s stock option activity since December 31, 2021: Weighted Weighted Average Average Remaining Aggregate Number of Exercise Contractual Intrinsic Shares Price Term Value (in years) Outstanding as of December 31, 2021 6,596,969 $ 4.10 5.20 38,524 Granted 1,418,224 8.03 Exercised ( 1,864,961 ) 1.11 8,475 Canceled / forfeited ( 218,490 ) 6.04 Outstanding as of December 31, 2022 5,931,742 5.91 6.14 2,245 Options exercisable as of December 31, 2022 3,079,121 3.58 4.12 2,245 Options vested or expected to vest as of December 31, 2022 5,490,567 $ 5.68 5.95 2,245

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense (Benefit)	The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2022, 2021, and 2020: Year Ended December 31, 2022 2021 2020 Income tax expense (benefit): Current tax expense (benefit) Federal $ 178 $ - $ ( 106 ) State 2,575 899 505 Foreign 17 ( 39 ) 19 Total current tax expense 2,770 860 418 Deferred tax expense (benefit) Federal 5,446 ( 30,506 ) 109 State ( 3,466 ) ( 1,470 ) - Foreign - - 3 Total deferred tax expense (benefit) 1,980 ( 31,976 ) 112 Total income tax expense (benefit) $ 4,750 $ ( 31,116 ) $ 530
Component of Company's Deferred Tax Assets and Liabilities	Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2022 and 2021 are as follows: December 31, 2022 2021 Net operating loss carryforwards Federal $ 9,327 $ 21,760 State 960 1,612 Foreign 16 16 Other 5,658 7,556 Capitalized R&D 8,849 - Stock-based compensation 1,453 676 Finance leases 126 632 Operating leases 13,164 12,918 Fixed assets 3,921 2,748 Net deferred tax assets before valuation allowance 43,474 47,918 Valuation allowance - - ROU assets ( 10,724 ) ( 12,273 ) Intangibles ( 2,736 ) ( 3,651 ) Net deferred tax assets $ 30,014 $ 31,994
Schedule of Effective Income Tax Rate Reconciliation	The differences between income taxes expected at the U.S. federal statutory income tax rate of 21 % and the reported consolidated income tax benefit (expense) are summarized as follows: December 31, 2022 2021 2020 U.S. federal statutory income tax rate 21.0 % 21.0 % 21.0 % Federal valuation allowance - % ( 70.6 ) % ( 28.9 ) % State valuation allowance - % ( 9.1 ) % ( 4.8 ) % Return to provision and other adjustments ( 1.6 ) % - - Prior period correction ( 8.5 ) % - - State and local income taxes 6.8 % 6.8 % 6.2 % Nondeductible expenses 1.3 % 0.8 % 6.0 % Executive compensation limited by 162(m) 3.1 % - - Foreign rate differential 0.1 % - - Uncertain tax position reserves 0.3 % 0.9 % 0.4 % Research and development credits 0.9 % 0.9 % 3.0 % Effective income tax rate 23.4 % ( 49.3 ) % 2.9 %
Schedule of Unrecognized Tax Benefits Roll Forward	A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below: Year Ended December 31, 2022 2021 2020 Gross balance at beginning of year $ 1,612 $ 2,123 $ 2,618 Additions based on tax positions related to the current period 206 153 111 Reductions for tax positions of prior years ( 186 ) ( 664 ) ( 606 ) Gross balance at end of year $ 1,632 $ 1,612 $ 2,123

Earnings (Loss) Per Share (EP_2

Earnings (Loss) Per Share (EPS) (Tables)	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the Class A common stockholder s is as follows: Year Ended December 31, 2022 2021 2020 Numerator: Net Income $ 15,532 $ 94,202 $ 17,234 Denominator: Weighted average common shares outstanding —basic 130,070,231 128,331,022 107,737,936 Dilutive effect of restricted stock units 149,215 469,123 135,932 Dilutive effect of options 2,163,706 4,862,514 3,486,963 Weighted-average common shares outstanding—diluted 132,383,152 133,662,659 111,360,831 Earnings per share—basic $ 0.12 $ 0.73 $ 0.16 Earnings per share—diluted $ 0.12 $ 0.70 $ 0.15

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2022
Leases [Abstract]
Schedule of Accrued But Unpaid Lease Obligations	The accrued but unpaid lease obligations as well as the related interest accru als are shown below. December 31, 2022 2021 Principal portion of rent in arrears $ 5,779 $ 7,246 Unpaid operating and common area maintenance costs - 558 Total accrued but unpaid lease obligations $ 5,779 $ 7,804 Accrued interest on accrued but unpaid lease obligations $ 1,956 $ 1,938
Schedule of Lease Cost	The components of lease cos t were as follows: Classification Year Ended Year Ended Finance lease Amortization of right-of-use assets COGS and SG&A $ 213 $ 1,707 Interest on lease liabilities Interest Expense 7 980 Total Finance lease cost 220 2,687 Operating lease cost COGS, R&D, SG&A 9,570 7,066 Short-term lease cost COGS, R&D, SG&A 2,951 2,869 Variable lease cost COGS, R&D, SG&A 5,082 4,808 Total lease cost $ 17,823 $ 17,430
Summary of Balance Sheet Information Related To Finance Leases	Supplemental balance sheet information r elated to finance leases was as follows: December 31, December 31, 2022 2021 Property and equipment, gross $ 1,174 $ 1,174 Accumulated depreciation ( 1,174 ) ( 961 ) Property and equipment, net $ - $ 213 Current portion of finance lease obligations $ - $ 200 Finance lease long-term obligations - - Total finance lease liabilities $ - $ 200
Summary of Cash Flow Information Related To Leases	Supplemental cash flow information relate d to leases was as follows: Year Ended Year Ended Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 9,273 $ 7,276 Operating cash flows for finance leases $ 7 $ 1,427 Financing cash flows for finance leases $ 200 $ 2,630 Right-of-use assets obtained in exchange for lease obligations Operating leases $ 1,350 $ 53,793 Finance leases $ - $ - December 31, December 31, 2022 2021 Weighted-average remaining lease term Finance leases - 0.45 Operating leases 7.54 8.22 December 31, December 31, 2022 2021 Weighted-average discount rate Finance leases - 11.30 % Operating leases 4.61 % 4.51 %
Summary of Maturities of Lease Liabilities	As of December 31, 2022, the maturities of lease liabilities were as follows: Operating leases 2023 $ 13,747 2024 7,366 2025 7,578 2026 7,489 2027 8,002 Thereafter 18,613 Total lease payments 62,795 Less: interest ( 9,773 ) Total lease liabilities $ 53,022

Nature of the Business and Basi

Nature of the Business and Basis of Presentation - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2022 Segments
Business Acquisition [Line Items]
Number of Operating Segments	1
Number of Reportable Segments	1

Significant Accounting Polici_4

Significant Accounting Policies - Additional Information (Detail) - USD ($)		3 Months Ended	12 Months Ended
	Aug. 09, 2022	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Significant Accounting Policies [Line Items]
GPO Fees		$ 1,619,000	$ 6,654,000	$ 3,663,000	$ 3,572,000
Restricted Cash, Current			812,000	599,000
Operating lease liability			53,022,000
Right-of-use asset			43,192,000	49,144,000
Impairment of goodwill			0	0	0
Deferred Income tax benefit				48,252,000
Selling, General and Administrative Expenses
Significant Accounting Policies [Line Items]
Advertising Expense			$ 4,812,000	$ 5,522,000	$ 2,722,000
GPO Customers [Member]
Significant Accounting Policies [Line Items]
Settlement of previously disputed GPO fees	$ 3,300,000

Significant Accounting Polici_5

Significant Accounting Policies - Schedule of Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Accrued expenses and other current liabilities	$ 26,447	$ 34,119	$ 37,289
Total current liabilities	75,023	78,492	82,705
Total liabilities	183,690	194,744	201,924
Accumulated deficit	(45,301)	(61,746)	(60,833)
Total stockholders' equity	$ 265,669	241,528	241,335	$ 141,808	$ 52,022
As Previously Reported
Accrued expenses and other current liabilities		32,419	36,589
Total current liabilities		76,792	82,005
Total liabilities		193,044	201,224
Accumulated deficit		(60,046)	(60,133)
Total stockholders' equity		243,228	242,035
Adjustments
Accrued expenses and other current liabilities		1,700	700
Total current liabilities		1,700	700
Total liabilities		1,700	700
Accumulated deficit		(1,700)	(700)
Total stockholders' equity		$ (1,700)	$ (700)

Significant Accounting Polici_6

Significant Accounting Policies - Schedule of Consolidated Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net revenue	$ 97,117	$ 450,893	$ 467,359	$ 338,298
GrossProfit	72,037	345,874	353,160	250,979
Income from operations	(128)	22,304	72,218	26,700
Net income before income taxes	(868)	20,282	63,086	17,764
Net income	(913)	$ 15,532	94,202	$ 17,234
As Previously Reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net revenue	98,117		468,059
GrossProfit	73,037		353,860
Income from operations	872		72,918
Net income before income taxes	132		63,786
Net income	87		94,902
Adjustments
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net revenue	(1,000)		(700)
GrossProfit	(1,000)		(700)
Income from operations	(1,000)		(700)
Net income before income taxes	(1,000)		(700)
Net income	$ (1,000)		$ (700)

Significant Accounting Polici_7

Significant Accounting Policies - Schedule of Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net Income (loss)	$ (913)	$ 15,532	$ 94,202	$ 17,234
Changes in operating assets and liabilities:
Accrued expenses and other current liabilities	(3,828)	$ (11,850)	9,354	$ 1,443
As Previously Reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net Income (loss)	87		94,902
Changes in operating assets and liabilities:
Accrued expenses and other current liabilities	(4,828)		8,654
Adjustments
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net Income (loss)	(1,000)		(700)
Changes in operating assets and liabilities:
Accrued expenses and other current liabilities	$ 1,000		$ 700

Significant Accounting Polici_8

Significant Accounting Policies - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenues	$ 97,117	$ 450,893	$ 467,359	$ 338,298
As Previously Reported
Revenues	98,117		468,059
Adjustments
Revenues	(1,000)		(700)
Advanced Wound Care
Revenues	90,090	422,231	430,237	294,624
Advanced Wound Care | As Previously Reported
Revenues	90,950		430,839
Advanced Wound Care | Adjustments
Revenues	(860)		(602)
Surgical & Sports Medicine
Revenues	7,027	$ 28,662	37,122	$ 43,674
Surgical & Sports Medicine | As Previously Reported
Revenues	7,167		37,220
Surgical & Sports Medicine | Adjustments
Revenues	$ (140)		$ (98)

Summary of Significant Accounti

Summary of Significant Accounting Policies - Schedule of Miscellaneous Items (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
GPO Fees	$ 1,619	$ 6,654	$ 3,663	$ 3,572
PuraPly Revenue	52,800		198,050
As Previously Reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
GPO Fees	619		2,963
PuraPly Revenue	53,300		198,400
Adjustments
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
GPO Fees	1,000		700
PuraPly Revenue	$ (500)		$ (350)

Significant Accounting Polici_9

Significant Accounting Policies - Property, Plant and Equipment (Detail)	12 Months Ended
	Dec. 31, 2022
Leasehold improvements
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	Lesser of the life of the lease or the economic life of the asset
Building
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	30 years
Furniture and computers | Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	3 years
Furniture and computers | Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment | Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment | Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	10 years

Significant Accounting Polic_10

Significant Accounting Policies -Schedule of Finite-Lived Intangible Assets (Detail)	12 Months Ended
	Dec. 31, 2022
Trade names and trademarks | Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	1 year
Trade names and trademarks | Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Developed technology | Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	6 years
Developed technology | Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Customer relationships
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years
Non-compete agreements
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	5 years

Acquisition - Additional Inform

Acquisition - Additional Information (Detail) - USD ($) $ in Thousands		1 Months Ended	12 Months Ended
	Sep. 17, 2020	Apr. 30, 2022	Dec. 31, 2022	Dec. 31, 2020	Jun. 30, 2022
Payments​ to acquire businesses gross				$ 5,820
Business Acquisitions, Contingent Consideration Liability Noncurrent	$ 3,782				$ 0
CPN Biosciences, LLC
Business Acquisitions, Aggregate Consideration	19,024
Payments​ to acquire businesses gross	5,820
Consideration heldback	$ 1,436
Earnout Calculation	70%
CPN Biosciences, LLC | Total Consideration Including Holdback [Member]
Payments​ to acquire businesses gross	$ 6,427
CPN Biosciences, LLC | Payment Of Holdback [Member]
Payments​ to acquire businesses gross		$ 608
Common Stock | CPN Biosciences, LLC
Issuance of common stock associated with business acquisition	1,947,953		203,485	1,947,953
Common Stock | CPN Biosciences, LLC | Total Consideration Including Holdback [Member]
Business Acquisitions, Number Of Shares Issued	2,151,438
Business Acquisitions, Equity Interests Issued And Issuable	$ 8,815
Common Stock | CPN Biosciences, LLC | Payment Of Holdback [Member]
Issuance of common stock associated with business acquisition		203,485

Fair Value Measurement of Fin_3

Fair Value Measurement of Financial Instruments - Additional Information (Detail) - USD ($) $ in Thousands	Jun. 30, 2022	Sep. 17, 2020
Earnout liability	$ 0	$ 3,782

Fair Value Measurement of Fin_4

Fair Value Measurement of Financial Instruments - Fair value of the Company's Earnout liability (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value		$ (3,985)	$ 203
Fair Value, Inputs, Level 3
Business Acquisition, Contingent Consideration [Line Items]
Beginning balance	$ 0	3,985	0
Acquisition Date fair value			3,782
Change in fair value	0	(3,985)	203
Ending balance	$ 0	$ 0	$ 3,985

Accounts receivable, net - Summ

Accounts receivable, net - Summary of Accounts Receivable (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Receivables [Abstract]
Accounts receivable	$ 95,812	$ 87,613
Less—allowance for doubtful accounts	(6,362)	(5,153)
Accounts receivable	$ 89,450	$ 82,460

Accounts receivable, net - Su_2

Accounts receivable, net - Summary of Allowance for Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Balance	$ 5,153	$ 2,669
Additions	1,781	2,999	$ 1,183
Write-offs	(572)	(515)
Balance	$ 6,362	$ 5,153	$ 2,669

Inventories - Summary of Invent

Inventories - Summary of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Raw materials	$ 12,282	$ 9,023
Work in process	1,022	991
Finished goods	11,479	15,008
Inventory	$ 24,783	$ 25,022

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Inventory reserve and obsolescence charged to cost of goods	$ 9,648	$ 12,079	$ 3,050

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Subscriptions	$ 4,211	$ 2,745
Conferences and marketing expenses	106	538
Deposits	635	1,216
Insurance	54	358
Other	80	112
Prepaid Expense	$ 5,086	$ 4,969

Property and Equipment, Net (De

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Property and equipment, gross	$ 99,697	$ 89,433
Accumulated depreciation	(62,798)	(57,729)
Property, Plant and Equipment, Net, Total	102,463	79,160
Leasehold improvements
Property and equipment, gross	37,607	30,531
Building
Property and equipment, gross	4,943	4,943
Furniture, computers and equipment
Property and equipment, gross	57,147	53,959
Construction in progress
Property, Plant and Equipment, Net, Total	$ 65,564	$ 47,456

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Depreciation expense	$ 5,845	$ 5,781	$ 4,438
Sale and donation charges of equipment related to construction in progress	4,200
Cancellation fees to vendors	$ 632

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Original Cost	$ 58,523	$ 58,523
Accumulated Amortization	(37,734)	(32,850)
Net Book Value	20,789	25,673
Developed technology
Original Cost	32,620	32,620
Accumulated Amortization	(21,164)	(17,709)
Net Book Value	11,456	14,911
Trade names and trademarks
Original Cost	2,080	2,080
Accumulated Amortization	(1,393)	(1,183)
Net Book Value	687	897
Customer relationship
Original Cost	10,690	10,690
Accumulated Amortization	(2,450)	(1,381)
Net Book Value	8,240	9,309
Independent sales agency network
Original Cost	4,500	4,500
Accumulated Amortization	(4,500)	(4,500)
Patent
Original Cost	7,623	7,623
Accumulated Amortization	(7,623)	(7,623)
Non-compete agreements
Original Cost	1,010	1,010
Accumulated Amortization	(604)	(454)
Net Book Value	$ 406	$ 556

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Estimated future annual amortization expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
2023	$ 4,918
2024	3,403
2025	3,323
2026	3,043
2027	2,283
Thereafter	3,819
Net Book Value	$ 20,789	$ 25,673

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Goodwill	$ 28,772	$ 28,772
Amortization of Intangible Assets	$ 4,883	$ 4,949	$ 3,745

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Personnel costs	$ 17,113	$ 26,865
Royalties	3,320	3,458
Accrued but unpaid lease obligations and interest	2,463	3,963
Accrued settlement fee		700
Accrued taxes	2,625	1,160
Other	926	1,143
Total Accrued Expenses and Other Current Liabilities	$ 26,447	$ 37,289

Restructuring - Summary of liab

Restructuring - Summary of liability related to the restructuring activities (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	$ 3,168	$ 618
Expenses	2,268	4,704	$ 618
Cash distributions	(4,244)	(2,154)
Liability balance as of ending	1,192	3,168	618
Employee
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	2,517	618
Expenses	1,557	3,513	618
Cash distributions	(3,064)	(1,614)
Liability balance as of ending	1,010	2,517	$ 618
Other
Restructuring Cost and Reserve [Line Items]
Liability balance as of beginning	651
Expenses	711	1,191
Cash distributions	(1,180)	(540)
Liability balance as of ending	$ 182	$ 651

Restructuring - Additional Info

Restructuring - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Mar. 09, 2022 Employees	Oct. 21, 2020 Employees
Restructuring Cost and Reserve [Line Items]
Restructuring Charges | $	$ 2,268	$ 4,704	$ 618
Restructuring Reserve Current | $	$ 1,192	$ 3,168
Birmingham Restructuring
Restructuring Cost and Reserve [Line Items]
Number of employees to retention Benefits | Employees				25
La Jolla Restructuring
Restructuring Cost and Reserve [Line Items]
Number of employees to retention Benefits | Employees					65

Long-Term Debt Obligations (Det

Long-Term Debt Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Line of credit	$ 0	$ 0
Term loan	71,250	74,062
Less debt discount and debt issuance cost	(481)	(637)
Term loan, net of debt discount and debt issuance cost	$ 70,769	$ 73,425

Long-Term Debt Obligations - Ad

Long-Term Debt Obligations - Additional Information (Detail) - USD ($) $ in Thousands			12 Months Ended
	Aug. 06, 2021	Mar. 14, 2019	Dec. 31, 2022	Dec. 31, 2021
Loss on the extinguishment of debt				$ (1,883)
Line of credit			$ 0	0
Secured debt			71,250	74,062
Term payment			2,813	938
2019 Credit Agreement
Loss on the extinguishment of debt				(1,883)
Term payment	$ 70,559
2021 Credit Agreement
Financial covenants	Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants including the Consolidated Fixed Charge Coverage Ratio and Consolidated Total Net Leverage Ratio, tested quarterly. In addition, the Company is also required to make representations and warranties and comply with certain non-financial covenants that are customary in loan agreements of this type, including restrictions on the payment of dividends, repurchase of stock, incurrence of indebtedness, dispositions and acquisitions.
Debt Instrument, Description of Variable Rate Basis	For SOFR Loans, the interest rate is a per annum interest rate equal to the Adjusted Term SOFR plus an Applicable Margin between 2.00% to 3.25% based on the Total Net Leverage Ratio. For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) the Adjusted Term SOFR rate plus 1.0%, plus (2) an Applicable Margin between 1.00% to 2.25% based on the Total Net Leverage Ratio.
2021 Credit Agreement | Maximum [Member] | ABR Loans [Member] | Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	2.25%
2021 Credit Agreement | Maximum [Member] | SOFR Loans | Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	3.25%
2021 Credit Agreement | Minimum [Member] | ABR Loans [Member] | Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	1%
2021 Credit Agreement | Minimum [Member] | SOFR Loans | Applicable Margin [Member]
Debt instrument interest and applicable margin rate percentage	2%
Term Loan [Member] | 2019 Credit Agreement
Debt Instrument, Basis Spread on Variable Rate		3.75%
Debt Instrument, Description of Variable Rate Basis		annum interest rate equal to the greater of 3.75% above the Wall Street Journal Prime Rate and 9.25%
Additional Payment in Aggregate of the Principal Amount Percentage		6.50%
Fixed Interest Rate		9.25%
Debt instrument face amount		$ 40,000
Term Loan [Member] | 2021 Credit Agreement
Secured debt			71,250	$ 74,062
Debt Issuance Costs, Net	$ 604
Debt instrument face amount	75,000
Term Loan [Member] | 2021 Credit Agreement | September 30, 2021 through and including June 30, 2022
Debt instrument quarterly installment payment to original principal amount	469
Term Loan [Member] | 2021 Credit Agreement | September 30, 2022 through and including June 30, 2023
Debt instrument quarterly installment payment to original principal amount	938
Term Loan [Member] | 2021 Credit Agreement | September 30, 2023 through and including June 30, 2025
Debt instrument quarterly installment payment to original principal amount	1,406
Term Loan [Member] | 2021 Credit Agreement | September 30, 2025 and the last day of each quarter thereafter until August 6, 2026
Debt instrument quarterly installment payment to original principal amount	1,875
Revolving Credit Facility [Member] | 2019 Credit Agreement
Maximum borrowing capacity		$ 60,000
Line of credit maturity date		2024
Line of credit description of variable rate basis for advances under revolving facility		The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%.
Revolving Credit Facility [Member] | 2021 Credit Agreement
Line of credit			0
Maximum borrowing capacity	125,000		$ 125,000
Debt Issuance Costs, Net	$ 1,223
Revolving Credit Facility [Member] | 2021 Credit Agreement | Maximum [Member]
Line​ of credit ​facility​ unused​ capacity​ commitment​ fee​ percentage	0.45%
Revolving Credit Facility [Member] | 2021 Credit Agreement | Minimum [Member]
Line​ of credit ​facility​ unused​ capacity​ commitment​ fee​ percentage	0.25%

Long-Term Debt Obligations - Fu

Long-Term Debt Obligations - Future payments of term loan (Detail) $ in Thousands	Dec. 31, 2022 USD ($)
2023	$ 4,687
2024	5,625
2025	6,563
2026	54,375
Total	$ 71,250

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule Of Common Stock Shares Reserved For Future Issuance (Detail) - shares	Dec. 31, 2022	Dec. 31, 2021
Equity [Abstract]
Shares reserved for issuance for outstanding options	5,931,742	6,596,969
Shares reserved for issuance for outstanding restricted stock units	1,381,500	764,871
Shares reserved for issuance for future grants	11,394,962	5,644,691
Total shares of authorized common stock reserved for future issuance	18,708,204	13,006,531

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		12 Months Ended
	Nov. 30, 2020	Mar. 24, 2019	Dec. 31, 2022	Dec. 31, 2020	Dec. 31, 2021
Common stock, par value			$ 0.0001		$ 0.0001
Common stock, shares issued			131,647,677		129,408,740
Aggregate Purchase Price of Class A common stock				$ 64,729
Other underwriting expenses net of reimbursement by underwriters				4,647
Reimbursement of offering expenses included in prepaid expenses and other current assets				$ 1,009
Cash dividend			$ 0
2020 Underwritten Public Offering [Member]
Common stock, shares issued	19,916,708
Aggregate Purchase Price of Class A common stock	$ 64,729
Common stock price per share	$ 3.25
Shares offered in the underwritten public offering	17,500,000
Proceeds from issuance of common stock net of offering expense	$ 59,073
Other offering expense	5,656
Other underwriting expenses net of reimbursement by underwriters	4,647
Reimbursement of offering expenses included in prepaid expenses and other current assets	$ 1,009
Common Class A
Common stock, par value	$ 0.0001
Company issued acquisition of shares		728,548
Common stock voting rights			one

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Jun. 30, 2022	Dec. 31, 2019	Dec. 31, 2018
Fair value of option vested	$ 2,082	$ 813
Weighted average grant-date fair value	$ 3.94	$ 5.32
Number of options exercised	1,864,961
Restricted Stock Units [Member]
Unrecognized stock compensation expense	$ 5,692
Share-based compensation expected to be recognized over a weighted-average period	2 years 7 months 6 days
RSU granted during the period	979,257
Option Loans
Related Parties Notes Receivable			$ 334		$ 635
Number of shares as collateral for options loans					675,990
Number of options exercised		195,278
Option
Unrecognized stock compensation expense	$ 5,825
Share-based compensation expected to be recognized over a weighted-average period	2 years 7 months 9 days
Selling, General and Administrative Expenses
Share-based compensation expenses	$ 6,552	$ 3,864	$ 1,661
2003 and 2018 Stock Incentive Plan | Maximum
Share-based Compensation Arrangement by Share-based Payment Award vesting period	5 years
2003 and 2018 Stock Incentive Plan | Minimum
Share-based Compensation Arrangement by Share-based Payment Award vesting period	4 years
2003 and 2018 Stock Incentive Plan | Option
Stock option expiration period	10 years
Common Class A | 2018 Stock Incentive Plan
Common stock awards authorized				7,826,970		9,198,996

Share-Based Compensation - Sche

Share-Based Compensation - Schedule of Fair Value of Stock Options Granted to Employees and Directors (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Risk-free interest rate	1.92%	0.83%
Expected term (in years)	6 years 3 months	6 days 5 hours
Expected volatility	50.66%	39.31%
Expected dividend yield	0%	0%
Exercise price	$ 8.03	$ 13.57
Underlying stock price	$ 7.87	$ 13.57

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Restricted Stock Units (Detail) - Restricted Stock Units (RSUs) [Member]	12 Months Ended
	Dec. 31, 2022 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unvested at December 31, 2021 | shares	764,871
Unvested Granted | shares	979,257
Unvested Vested | shares	(249,106)
Unvested Canceled/Forfeited | shares	(113,522)
Unvested at December 31, 2022 | shares	1,381,500
Unvested at December 31, 2021 | $ / shares	$ 7.52
Unvested Granted | $ / shares	7.56
Unvested Vested | $ / shares	7.34
Unvested Canceled/Forfeited | $ / shares	7
Unvested at December 31, 2022 | $ / shares	$ 7.62

Share-Based Compensation - Su_2

Share-Based Compensation - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Number of Shares Outstanding	6,596,969
Number of Shares Granted	1,418,224	1,069,658
Number of Shares Exercised	(1,864,961)
Number of Shares Canceled / forfeited	(218,490)
Number of Shares Outstanding	5,931,742	6,596,969
Number of Shares Options Exercisable	3,079,121
Number of Shares Options vested or expected to vest	5,490,567
Weighted Average Exercise Price Outstanding	$ 4.10
Weighted Average Exercise Price Granted	8.03
Weighted Average Exercise Price Exercised	1.11
Weighted Average Exercise Price Cancelled / forfeited	6.04
Weighted Average Exercise Price Outstanding	5.91	$ 4.10
Weighted Average Exercise Price Options Exercisable	3.58
Weighted Average Exercise Price Options Vested or Expected to Vest	$ 5.68
Weighted Average Remaining Contractual Term (in years) Outstanding	6 years 1 month 20 days	5 years 2 months 12 days
Weighted Average Remaining Contractual Term (in years) Options Exercisable	4 years 1 month 13 days
Weighted Average Remaining Contractual Term (in years) Options Vested or Expected to Vest	5 years 11 months 12 days
Aggregate Intrinsic Value Outstanding	$ 2,245	$ 38,524
Aggregate Intrinsic Value Options Exercised	8,475
Aggregate Intrinsic Value Options Exercisable	2,245
Aggregate Intrinsic Value Options Vested or Expected to Vest	$ 2,245

Share-Based Compensation - Pare

Share-Based Compensation - Parenthetical (Detail) - shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Options granted	1,418,224	1,069,658

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current Income Tax Expense (Benefit), Continuing Operations [Abstract]
Federal	$ 178		$ (106)
State	2,575	$ 899	505
Foreign	17	(39)	19
Total current tax expense	2,770	860	418
Deferred tax expense (benefit)
Federal	5,446	(30,506)	109
State	(3,466)	(1,470)
Foreign			3
Total deferred tax expense (benefit)	1,980	(31,976)	112
Total income tax expense (benefit)	$ 4,750	$ (31,116)	$ 530

Income Taxes - Component of Com

Income Taxes - Component of Company's Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Deferred Tax Assets, Operating Loss Carryforwards, Components [Abstract]
Federal	$ 9,327	$ 21,760
State	960	1,612
Foreign	16	16
Other	5,658	7,556
Capitalized R&D	8,849
Stock-based compensation	1,453	676
Finance leases	126	632
Operating leases	13,164	12,918
Fixed assets	3,921	2,748
Net deferred tax assets before valuation allowance	43,474	47,918
ROU assets	(10,724)	(12,273)
Intangibles	(2,736)	(3,651)
Net deferred tax assets	$ 30,014	$ 31,994

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Detail)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
U.S. federal statutory income tax rate	21%	21%	21%
Federal valuation allowance		(70.60%)	(28.90%)
State valuation allowance		(9.10%)	(4.80%)
Return to provision and other adjustments	(1.60%)
Prior period correction	(8.50%)
State and local income taxes	6.80%	6.80%	6.20%
Nondeductible expenses	1.30%	0.80%	6%
Executive compensation limited by 162(m)	3.10%
Foreign rate differential	0.10%
Uncertain tax position reserves	0.30%	0.90%	0.40%
Research and development credits	0.90%	0.90%	3%
Effective income tax rate	23.40%	(49.30%)	2.90%

Income Taxes - Schedule of Unre

Income Taxes - Schedule of Unrecognized Tax Benefits Roll Forward (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Gross balance at beginning of year	$ 1,612	$ 2,123	$ 2,618
Additions based on tax positions related to the current period	206	153	111
Reductions for tax positions of prior years	(186)	(664)	(606)
Gross balance at end of year	$ 1,632	$ 1,612	$ 2,123

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Federal corporate income tax rate	21%	21%	21%
Operating loss carryforwards research and development credit	$ 443
Unrecognized tax benefits	$ 2,642	$ 2,307	$ 2,870
Description of tax benefits upon ultimate settlement	The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.
Income tax penalities and interest expense	$ 404	330
Deferred income tax (expense) benefit		$ 48,252
Subsidiaries [Member]
Net operating loss cary forward	16
Domestic Tax Authority [Member]
Operating Loss Carryforwards	44,390
State and Local Jurisdiction [Member] | Expiration December 31, 2031 through 2038
Operating Loss Carryforwards	$ 14,293

Earnings (Loss) Per Share (EP_3

Earnings (Loss) Per Share (EPS) - Basic and diluted net loss per share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net income	$ (913)	$ 15,532	$ 94,202	$ 17,234
Weighted-average common shares outstanding—basic		130,070,231	128,331,022	107,737,936
Weighted-average common shares outstanding—diluted		132,383,152	133,662,659	111,360,831
Earnings per share-basic		$ 0.12	$ 0.73	$ 0.16
Earnings per share-diluted		$ 0.12	$ 0.70	$ 0.15
Restricted Stock Units [Member]
Dilutive effect of awards		149,215	469,123	135,932
Employee Stock Option
Dilutive effect of awards		2,163,706	4,862,514	3,486,963

Earnings (Loss) Per Share (EP_4

Earnings (Loss) Per Share (EPS) - Additional Information (Detail) - shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Earnings Per Share [Abstract]
Anti-dilutive shares excluded from the diluted EPS	3,445,191	994,168	1,792,085

Leases - Additional Information

Leases - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended		60 Months Ended
	Aug. 11, 2021	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2027
Variable lease expenses		$ 5,082	$ 4,808
275 Dan Road SPE LLC [Member]
Purchase of building under the lease amount	$ 6,013
Percentage of amount required to pay for the accrued but unpaid lease obligations associated with building	50%
Dan Road Leases [Member] | Scenario Forecast [Member]
Variable lease expenses				$ 8,060
Fleet Lease
Lessee, operating lease, term of contract		367 days
Maximum
Lessee, operating lease, renewal term		10 years
Minimum
Lessee, operating lease, renewal term		5 years

Leases - Schedule of Accrued bu

Leases - Schedule of Accrued but Unpaid Lease Obligations (Detail) - Accrued But Unpaid Lease Obligation [Member] - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Accrued interest on accrued but unpaid lease obligations	$ 1,956	$ 1,938
Principal [Member]
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Total accrued but unpaid lease obligations	5,779	7,246
Common Area Maintenance [Member]
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Total accrued but unpaid lease obligations		558
Principal, Interest and CAM [Member]
Schedule Of Accrued But Unpaid Lease Obligations [Line Items]
Total accrued but unpaid lease obligations	$ 5,779	$ 7,804

Leases - Schedule of Lease Cost

Leases - Schedule of Lease Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Finance lease Amortization of right-of-use assets	$ 213	$ 1,707
Finance lease Interest on lease liabilities	7	980
Total Finance lease cost	220	2,687
Operating lease cost	9,570	7,066
Short-term lease cost	2,951	2,869
Variable lease cost	5,082	4,808
Total lease cost	$ 17,823	$ 17,430

Leases - Summary of Balance She

Leases - Summary of Balance Sheet Information Related To Finance Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Lessee Disclosure [Abstract]
Property and equipment, gross	$ 1,174	$ 1,174
Accumulated depreciation	$ (1,174)	(961)
Property and equipment, net		213
Current portion of finance lease obligations		200
Total lease liabilities		$ 200
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]		Property, Plant and Equipment, Net
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]		Current portion of finance lease obligations

Leases - Summary of Cash Flow I

Leases - Summary of Cash Flow Information Related To Leases (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 9,273	$ 7,276
Operating cash flows for finance leases	7	1,427
Financing cash flows for finance leases	200	2,630	$ 2,427
Right-of-use assets obtained in exchange for lease obligations
Operating leases	$ 1,350	$ 53,793
Weighted-average remaining lease term
Finance leases		5 months 12 days
Operating leases	7 years 6 months 14 days	8 years 2 months 19 days
Weighted-average discount rate
Finance leases		11.30%
Operating leases	4.61%	4.51%

Leases - Summary of Maturities

Leases - Summary of Maturities of Lease Liabilities (Detail) $ in Thousands	Dec. 31, 2022 USD ($)
Lessee Disclosure [Abstract]
2023	$ 13,747
2024	7,366
2025	7,578
2026	7,489
2027	8,002
Thereafter	18,613
Total lease payments	62,795
Less: interest	(9,773)
Total lease liabilities	$ 53,022

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Feb. 14, 2020	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2017
Accrued Legal Expenses		$ 150	$ 150
Gain on litigation settlement				$ 2,246
Selling, General and Administrative Expenses
Royalty Expense		7,279	5,929	4,370
License Agreement University
Accrued Royalties		1,187	1,187
Royalty Expense		$ 0	$ 0	$ 0
NuTech Medical
Deferred Acquisition Cost Paid					$ 2,500
The amount, if any, of the remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical is currently in dispute.					5,000
Business Combination Deferred Consideration					$ 7,500
Agreement cancellation charges paid	$ 1,950
Consulting service and royalty payment term	15 years
Damages awarded	$ 4,000
Loss contingency damages paid	2,000
Loss contingency value of each instalment to be paid	500
Loss contigency damages payable	$ 2,000

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Selling, General and Administrative Expenses
Related Party Transaction, Amounts of Transaction	$ 179
Option Loans
Related Parties Notes Receivable		$ 334	$ 635
Proceeds from Collection of Long-term Loans to Related Parties	$ 334
Liquidity Loan [Member]
Related Parties Notes Receivable		$ 100
Maximum [Member] | Liquidity Loan and Option Loans
Interest Rate	3.86%
Minimum [Member] | Liquidity Loan and Option Loans
Interest Rate	2.30%

Employee Benefit Plan - Additio

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Retirement Benefits [Abstract]
Company made employer contributions	$ 6,601	$ 3,092	$ 2,731

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) $ in Millions			12 Months Ended
	Feb. 22, 2023 shares	Feb. 03, 2023 USD ($) Employees	Dec. 31, 2022 shares	Dec. 31, 2021 shares
Options granted			1,418,224	1,069,658
Restricted Stock Units [Member]
RSU granted during the period			979,257
Subsequent Event [Member]
Share-based Compensation Arrangement by Share-based Payment Award vesting period	4 years
Severance payments | $		$ 1.7
Number of reduction in employees | Employees		70
Percentage of reduction in employees		7%
Subsequent Event [Member] | Restricted Stock Units [Member]
RSU granted during the period	2,868,531
Subsequent Event [Member] | Options [Member]
Options granted	3,556,282